Document Detail


The effect of prolonged cardioplegic arrest on long-term ventricular function.
MedLine Citation:
PMID:  6179189     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
R M Engelman; R E Gianelly; J H Rousou; S M Zu'bi
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Thoracic and cardiovascular surgeon     Volume:  29     ISSN:  0171-6425     ISO Abbreviation:  Thorac Cardiovasc Surg     Publication Date:  1981 Aug 
Date Detail:
Created Date:  1982-09-10     Completed Date:  1982-09-10     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7903387     Medline TA:  Thorac Cardiovasc Surg     Country:  GERMANY, WEST    
Other Details:
Languages:  eng     Pagination:  223-6     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Coronary Disease / 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:
1 RO1 HL 22559-02/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
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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