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Invasive Assessment of the Myocardial Microcirculation during Beating Heart Coronary Artery Bypass Grafting
Coronary artery bypass grafting may be associated with several cardiac complications, including ischemia, acute myocardial infarction, arrhythmias, or hemodynamic instability. Accumulating evidence suggests that well-developed coronary collateral circulation may protect against adverse effects, incl...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141187/ https://www.ncbi.nlm.nih.gov/pubmed/32121485 http://dx.doi.org/10.3390/jcm9030663 |
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author | Hellmann, Marcin Piotrowski, Jakub Kaszubowski, Mariusz Dudziak, Maria Anisimowicz, Lech |
author_facet | Hellmann, Marcin Piotrowski, Jakub Kaszubowski, Mariusz Dudziak, Maria Anisimowicz, Lech |
author_sort | Hellmann, Marcin |
collection | PubMed |
description | Coronary artery bypass grafting may be associated with several cardiac complications, including ischemia, acute myocardial infarction, arrhythmias, or hemodynamic instability. Accumulating evidence suggests that well-developed coronary collateral circulation may protect against adverse effects, including myocardial ischemia. Assessment of myocardial microvascular perfusion is, therefore, of great clinical interest in beating heart surgery. In this paper, myocardial microvascular perfusion is continuously assessed on the beating heart using laser Doppler flowmetry in consecutive patients who underwent coronary artery bypass grafting procedures. No significant (p = 0.110) differences were found between the averaged perfusion signal (n = 42) at the baseline, during artery occlusion, or after reperfusion (732.4 ± 148.0 vs. 711.4 ± 144.1 vs. 737.0 ± 141.2, respectively). In contrast, significantly different (p < 0.001) mean perfusion signals (n = 12) were found (805.4 ± 200.1 vs. 577.2 ± 212.8 vs. 649.3 ± 220.8) in a subset of patients who presented with hemodynamic instability and myocardial ischemia. Additionally, a strong positive correlation between the plasma levels of high-sensitivity troponin I and perfusion decrease level after artery occlusion was found (r = 0.854, p < 0.001). This study argues that myocardial microvascular perfusion remains constant during coronary artery bypass grafting on the beating heart in advanced coronary artery disease. This phenomenon is most likely due to an extensive coronary collateral circulation. |
format | Online Article Text |
id | pubmed-7141187 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-71411872020-04-10 Invasive Assessment of the Myocardial Microcirculation during Beating Heart Coronary Artery Bypass Grafting Hellmann, Marcin Piotrowski, Jakub Kaszubowski, Mariusz Dudziak, Maria Anisimowicz, Lech J Clin Med Article Coronary artery bypass grafting may be associated with several cardiac complications, including ischemia, acute myocardial infarction, arrhythmias, or hemodynamic instability. Accumulating evidence suggests that well-developed coronary collateral circulation may protect against adverse effects, including myocardial ischemia. Assessment of myocardial microvascular perfusion is, therefore, of great clinical interest in beating heart surgery. In this paper, myocardial microvascular perfusion is continuously assessed on the beating heart using laser Doppler flowmetry in consecutive patients who underwent coronary artery bypass grafting procedures. No significant (p = 0.110) differences were found between the averaged perfusion signal (n = 42) at the baseline, during artery occlusion, or after reperfusion (732.4 ± 148.0 vs. 711.4 ± 144.1 vs. 737.0 ± 141.2, respectively). In contrast, significantly different (p < 0.001) mean perfusion signals (n = 12) were found (805.4 ± 200.1 vs. 577.2 ± 212.8 vs. 649.3 ± 220.8) in a subset of patients who presented with hemodynamic instability and myocardial ischemia. Additionally, a strong positive correlation between the plasma levels of high-sensitivity troponin I and perfusion decrease level after artery occlusion was found (r = 0.854, p < 0.001). This study argues that myocardial microvascular perfusion remains constant during coronary artery bypass grafting on the beating heart in advanced coronary artery disease. This phenomenon is most likely due to an extensive coronary collateral circulation. MDPI 2020-03-01 /pmc/articles/PMC7141187/ /pubmed/32121485 http://dx.doi.org/10.3390/jcm9030663 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Hellmann, Marcin Piotrowski, Jakub Kaszubowski, Mariusz Dudziak, Maria Anisimowicz, Lech Invasive Assessment of the Myocardial Microcirculation during Beating Heart Coronary Artery Bypass Grafting |
title | Invasive Assessment of the Myocardial Microcirculation during Beating Heart Coronary Artery Bypass Grafting |
title_full | Invasive Assessment of the Myocardial Microcirculation during Beating Heart Coronary Artery Bypass Grafting |
title_fullStr | Invasive Assessment of the Myocardial Microcirculation during Beating Heart Coronary Artery Bypass Grafting |
title_full_unstemmed | Invasive Assessment of the Myocardial Microcirculation during Beating Heart Coronary Artery Bypass Grafting |
title_short | Invasive Assessment of the Myocardial Microcirculation during Beating Heart Coronary Artery Bypass Grafting |
title_sort | invasive assessment of the myocardial microcirculation during beating heart coronary artery bypass grafting |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141187/ https://www.ncbi.nlm.nih.gov/pubmed/32121485 http://dx.doi.org/10.3390/jcm9030663 |
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