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Renal Outcomes and Myocardial Performance after On-Pump beating heart versus Conventional On-Pump Surgery in Patients with Preoperative Low Glomerular Filtration Rate

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World Journal of Cardiovascular Diseases 2016年第11期6卷 433-445页

作者： Salih Colak Davut Azboy Zeki Temizturk Hakan Atalay Omer Faruk Dogan Dilek Dogan Emjed Khalil Kenan Abdurrahman Kara Department of Cardiology The Health and Science University Adana Numune Education and Training Hospital Adana Turkey Department of Cardiovascular Surgery The Health and Science University Elazig Education and Training Hospital Elazig Turkey Department of Cardiovascular Surgery Mersin Private Middle-East Hospital Mersin Turkey Department of Cardiovascular Surgery The Health and Science University Adana Numune Education and Training Hospital Adana Turkey Department of Dietetic and Parenteral Nutrition The Health and Science University Adana Numune Education and Training Hospital Adana Turkey Department of Cardiovascular Surgery The Private Medicana ?aml?ca Hospital Istanbul Turkey

Objective: Acute kidney disease develops 16% - 30% of patients with preoperative impaired renal functions. Our aim of this study was to compare postoperative renal outcomes using two open heart surgery techniques, on-pump beating heart (OPBH) and conventional on-pump (COP), in patients who have preoperative low glomerular filtration rate (eGFR) as an indicator of creatinine clearance. Methods: From 2004 to 2015, 341 patients with preoperative creatinine clearance were lower than 90 ml/min/1.73m2 were selected for this study. On-Pump beating heart was performed in 111 patients (Group I). Conventional on-pump technique was used in 200 patients. In the remaining patients, we measured postoperative Tumor Necrosis Factor Alpha (TNF-alpha), cardiac troponin I (cTn-I), Brain natriuretic peptid (NT-Pro- BNP), creati-nine (Cr), blood urea nitrogen (BUN) and postoperative eGFR daily until day four after surgery. Results: There were no differences in baseline levels of TNF-alpha, NT-Pro-BNP, BUN, cTn-I, Cr levels between the groups. Cardiopulmonary bypass (CPB) time were much longer and cumulative inotrope use was significantly higher in patients underwent COP (P Conclusion: Our study showed that on-pump beating heart CABG technique provides a morbidity benefit and is associated with a lower risk of peroperative LOS in patients with mild renal disfunction. Our study results suggest that OPBH is superior to the COP in terms of postoperative renal injury and cardiac mediators.

关键词： Open heart Surgery beating heart Postoperative Renal Failure

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Assessment of myocardial viability using a minimally invasive laser Doppler flowmetry on pig model

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Journal of Innovative Optical Health Sciences 2021年第2期4卷 51-57页

作者： Karina Litvinova Berthold Stegemann Francisco Leyva Aston Medical School Aston University Aston TriangleB47ETBirminghamUK Cardiology Department Queen Elizabeth Hospital Mindelsohn WayB152THBirminghamUK

Background:The intra-operative real-time assessment of tissue viability can potentially improve therapy delivery and clinical outcome in cardiovascular *** ablation therapy for the treatment of supraventricular or ventricular arrhythmia continues to be done without being able to assess if the intended lesion and lesion size have been ***,we report a method for continuous measurements of cardiac muscle microcirculation to provide an instrument for real-time ablation ***:We performed two acute open chest animal studies to assess the ability to perform real-time monitoring of creation and size of ablation lesion using a standard RF irrigated *** ablation and laser Doppler were applied to different endocardial areas of alive open-chest ***:We performed two experiments at three different RF ablation energy setting and different ablation ***-fusion signals before and after ablation were found extensively and distinctively *** in-creasing the ablation energy and time,the perfusion signal was ***:In vivo assessing the local microcirculation during RF ablation by laser Doppler can potentially be useful to differentiate between viable and nonviable ablated beating heart in real time.

关键词： beating heart RF ablation perfusion real-time monitoring myocardial microcirculation

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Conventional Coronary Artery Bypass Graft Surgery

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World Journal of Cardiovascular Surgery 2016年第4期6卷 55-60页

作者： Dominic Emerson Gregory Trachiotis Resident in Surgery Georgetown University Washington DC USA Division of Cardiothoracic Surgery and heart Center Veterans Affairs Medical Center Washington DC USA The George Washington University Medical Center Washington DC USA

Coronary artery bypass grafting (CABG) remains one of the most common procedures worldwide, and remains the gold standard therapy for symptomatic coronary artery disease (CAD) that involves the left main coronary artery, triple vessel CAD with or without left ventricular dysfunction, and other complex coronary CAD not amenable to percutaneous intervention, especially in diabetic patients or those with chronic total coronary occlusion. The majority of CABG operations are performed utilizing cardiopulmonary bypass, though beating heart or off-pump strategies have gained popularity by some surgeons. This review focuses on current technical strategies, and advances in conduit harvest and utility, and fundamental management components of cardiopulmonary bypass and beating heart principles.

关键词： Cardiopulmonary Bypass beating heart Mini-Circuit

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