Document Detail

Perioperative assessment of the quality of myocardial protection.
MedLine Citation:
PMID:  2093368     Owner:  NLM     Status:  MEDLINE    
Perioperative myocardial protection constitutes one of the major advances of modern cardiac surgery, but perioperative assessment of its quality is difficult in clinical practice. This review details our approach to myocardial protection in specific situations, as well as the techniques we use to assess it in three different settings: Is distribution of antegrade cardioplegia homogeneous in patients presenting coronary artery stenosis? The problem was to determine if cardioplegic solutions used antegradely or retrogradely could represent a reliable echographic contrast for myocardial imaging in coronary artery disease patients and normal coronary artery patients, and further if significant differences of myocardial contrast exist between the two methods. Does warm reperfusion cardioplegia improve postoperative myocardial function in patients with an ejection fraction (EF) less than 35%? Pre- and postoperative hemodynamic workup with construction of Starling curves were used to answer this question. Does reperfusion of ischemic hearts induce free radical formation in humans? Deleterious effects of reperfusion are usually determined by studying the effects of free radicals on the myocardium, by determining the concentrations of substances that reflect the degree of membrane phospholipid destruction. However, the specificity and the sensitivity of such assays are low. We recently described white cell chromosomal aberrations secondary to free radical formation, after ischemic and reperfusion injury. Values obtained are expressed as the percentage of the total number of chromosomes. Although specialized laboratory techniques are required, this test is highly accurate.
J N Fabiani; V Jebara; A Carpentier
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy     Volume:  4 Suppl 4     ISSN:  0920-3206     ISO Abbreviation:  Cardiovasc Drugs Ther     Publication Date:  1990 Aug 
Date Detail:
Created Date:  1991-06-27     Completed Date:  1991-06-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8712220     Medline TA:  Cardiovasc Drugs Ther     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  797-803     Citation Subset:  IM    
Cardiovascular Surgery Department, Hôpital Broussais, Paris, France.
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MeSH Terms
Chromosome Aberrations
Coronary Disease / genetics,  physiopathology,  surgery*
Free Radicals
Heart Arrest, Induced / methods
Heart Valve Diseases / genetics,  physiopathology,  surgery*
Intraoperative Care / methods
Myocardial Reperfusion Injury / etiology
Random Allocation
Stroke Volume
Reg. No./Substance:
0/Free Radicals

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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