| The effect of prolonged cardioplegic arrest on long-term ventricular function. | |
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MedLine Citation:
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PMID: 6179189 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Twenty-five patients (15 coronary revascularizations and 10 valve replacements) having ischemic arrest times longer than 120 minutes (121 to 184 min) were studied by scintigraphy 7 to 27 months after operation. We sought to define if prolonged cardioplegic arrest could be correlated with late postoperative ventricular functional deterioration. Each patient had serial enzymes, EKG analyses, and a technetium pyrophosphate (PYP) scan immediately following operation to determine if an intraoperative infarct occurred which could predispose to functional deterioration. One coronary bypass patient (6.7%) suffered a perioperative myocardial infarct. After a follow-up period of 7 to 25 (mean 17.9) months, none of the 15 patients has developed recurrent angina, infarction or congestive heart failure. Comparing preoperative and late postoperative ventricular function, 3 patients (20%) had a greater than 10% fall in ejection fraction (EF) and 3 (20%) a greater than 10% rise. Mean EF (15 patients) prior to operation was 57.8 +/- 4.7% and at restudy 59.0 +/- 4.6%. One valve replacement patient (10%) suffered a perioperative infarction. After a follow-up period of 16 to 27 (mean 19.9) months, all patients continue to do well. Comparing preoperative to late postoperative ventricular function, 3 patients (30%), had a greater than 10% fall in EF and 2 (20%) a greater than 10% rise. Mean EF (10 patients) prior to operation was 60.5 +/- 5.0% and at restudy 60.1% +/- 5.8%. It is concluded that prolongation of cardioplegic arrest beyond 2 hours is well-tolerated in most patients. Routine early postoperative tests were not useful in prognosticating late functional deterioration in 4 of 6 patients not suffering a perioperative infarction, and in these patients depressed function may be secondary to myocardial fibrosis. |
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Authors:
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R M Engelman; R E Gianelly; J H Rousou; S M Zu'bi |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: The Thoracic and cardiovascular surgeon Volume: 29 ISSN: 0171-6425 ISO Abbreviation: Thorac Cardiovasc Surg Publication Date: 1981 Aug |
Date Detail:
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Created Date: 1982-09-10 Completed Date: 1982-09-10 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 7903387 Medline TA: Thorac Cardiovasc Surg Country: GERMANY, WEST |
Other Details:
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Languages: eng Pagination: 223-6 Citation Subset: IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Coronary Disease
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physiopathology,
surgery Creatine Kinase / analysis Follow-Up Studies Heart Arrest, Induced / adverse effects* Heart Valve Diseases / physiopathology, surgery Heart Valve Prosthesis* Heart Ventricles / physiopathology* Humans Intraoperative Complications Isoenzymes Myocardial Infarction / etiology Myocardial Revascularization* |
| Grant Support | |
ID/Acronym/Agency:
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1 RO1 HL 22559-02/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Isoenzymes; EC 2.7.3.2/Creatine Kinase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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