Document Detail


Is a left ventricular vent necessary for coronary artery bypass operations performed with cardioplegic arrest?
MedLine Citation:
PMID:  6604196     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The need for ventricular venting with hypothermic cardioplegic arrest is controversial. We report an evaluation of the need for left ventricular venting in a canine model that closely simulates conditions during routine coronary artery bypass grafting (CABG). Thirty-five dogs were placed on cardiopulmonary bypass for 60 minutes of hypothermic cardioplegic arrest (18 vented, 17 nonvented) and then reperfused for 30 minutes. Myocardial temperature and left atrial pressure (LAP) were recorded continuously. Before and 30 minutes after hypothermic cardioplegic arrest, left ventricular function curves were generated (six vented, six nonvented), and biopsy specimens of the left ventricle were taken for adenosine triphosphate (ATP) determinations (11 vented, 10 nonvented) and semiquantitative grading of mitochondrial ultrastructure (six vented, six nonvented). LAP in nonvented dogs was 7.4 mm Hg during hypothermic cardioplegic arrest and 5.0 mm Hg during reperfusion. Temperature during hypothermic cardioplegic arrest was 12.3 degrees C in vented dogs and 11.3 degrees C in nonvented dogs (p = 0.5). There were no differences in left ventricular function or preservation of mitochondrial ultrastructure between vented and nonvented dogs. ATP after hypothermic cardioplegic arrest was 96.6% of control (4.30 microM/gm) in vented dogs and 94.6% (4.37 microM/gm) in nonvented dogs (p = 0.7). The absence of left ventricular venting did not lead to ventricular distention or more rapid rewarming. These data in vented dogs and nonvented dogs strongly support the belief that left ventricular venting is not necessary during routine CABG.
Authors:
R H Breyer; J W Meredith; S A Mills; A Trillo; M L Barringer; Z K Shihabi; H M Schey; A R Cordell
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  86     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1983 Sep 
Date Detail:
Created Date:  1983-10-08     Completed Date:  1983-10-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  338-49     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adenosine Triphosphate / analysis
Animals
Blood Pressure
Body Surface Area
Cardiac Output
Coronary Artery Bypass / methods*
Dogs
Heart Arrest, Induced*
Heart Atria / physiopathology
Heart Ventricles / analysis,  surgery*
Myocardium / analysis,  ultrastructure
Stroke Volume
Chemical
Reg. No./Substance:
56-65-5/Adenosine Triphosphate

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


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