Document Detail


Metabolic and hemodynamic features of elderly patients undergoing beating heart coronary artery bypass graft surgery.
MedLine Citation:
PMID:  16778757     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Coronary artery bypass graft (CABG) surgery, nowadays, is increasingly performed in patients who are older and have more comorbidities than subjects operated on a decade ago. In this study, we investigated metabolic and hemodynamic features of elderly patients with single vessel coronary artery disease (CAD), undergoing beating heart coronary artery bypass graft (BHCABG) surgery. METHODS: Twenty-five elderly patients, ages 73-78 years, with isolated left anterior descending artery (LAD) disease, were enrolled and compared to a younger similar group of 25 patients, mean age 48+/-1.2 years. A single vessel left internal mammary artery (LIMA) to LAD BHCABG was performed in all patients. Duration of temporary LAD occlusion was 9.8+/-0.5 min in the elderly group, and 10+/-0.4 min in the younger group. Myocardial arterial-venous differences in glucose, lactate, and creatine phosphokinase (CPK) were performed at different time points: preoperatively in the operating room (T0); at the end of the grafting procedure (T1); and before closing the chest (T2). Left ventricular stroke work index (LVSWI), as an indicator of global function of left ventricle, were recorded at T0, T1, T2, 6 (T3) and 48 (T4) hours postoperatively. RESULTS: Preoperative glucose extraction, observed in both groups, did not augment during and after surgery. In addition, neither lactate nor CPK were released in the coronary sinus during temporary LAD occlusion and following reperfusion in either group. Similarly, no significant changes in LVSWI were observed intra- and perioperatively between the two groups. CONCLUSIONS: Cardiac metabolism, hemodynamic parameters and global left ventricular function were not affected in either group by brief LAD occlusion during BHCABG, suggesting that BHCABG is a well-tolerated surgical approach, which can be safely attempted in patients of any age.
Authors:
C Chen-Scarabelli; E Pasini; G Ferrari; M Jabaren; J Abboud; R Raddino; M Ferrari; T M Scarabelli
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Minerva cardioangiologica     Volume:  54     ISSN:  0026-4725     ISO Abbreviation:  Minerva Cardioangiol     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-06-16     Completed Date:  2006-10-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0400725     Medline TA:  Minerva Cardioangiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  257-63     Citation Subset:  IM    
Affiliation:
Division of Cardiology, VA Ann Arbor Healthcare System, University of Michigan, USA.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Coronary Artery Bypass*
Coronary Artery Disease / metabolism*,  physiopathology*,  surgery
Female
Hemodynamics*
Humans
Male

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