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Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
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[Surgical revascularization of the myocardium in patients with chronic coronary disease and depressed left

Z Gasior1, A Bochenek, B Gorycki

  • 1I Klinika Kardiologii IK Sl. A. M. w Katowicach.

Polskie Archiwum Medycyny Wewnetrznej
|March 23, 1999
PubMed

Insights

Coronary artery bypass grafting (CABG) improves left ventricular (LV) systolic function in patients with severely depressed ejection fraction (LVEF) over one year. Both crystalloid and blood cardioplegia showed similar hemodynamic effects post-CABG.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Cardiovascular Physiology

Background:

  • Coronary artery bypass grafting (CABG) is crucial for ischemic heart disease with depressed left ventricular (LV) function.
  • While beneficial, CABG's precise impact on LV hemodynamics, especially with varying cardioplegia types, requires clarification.

Purpose of the Study:

  • To assess CABG's effect on LV hemodynamics in patients with low LV ejection fraction (LVEF).
  • To compare the influence of crystalloid (CC) versus blood (BC) cardioplegia on LV function post-CABG over one year.

Main Methods:

  • 122 patients with stable angina undergoing CABG were divided into LVEF ≤ 40% (Group I) and LVEF > 40% (Group II).
  • Patients were randomized to CC or BC cardioplegia.
  • Echocardiography assessed LVEF and wall motion score index (WMSI) pre-CABG and at 5 time points up to 1 year post-CABG.

Main Results:

  • In Group I (LVEF ≤ 40%), LVEF and WMSI significantly improved over 1 year (p < 0.001), particularly in those with LVEF ≤ 30%.
  • Group II (LVEF > 40%) showed transient LVEF deterioration 2-6 weeks post-CABG (p < 0.05).
  • No significant differences in LVEF or WMSI were observed between CC and BC subgroups (Ia vs Ib, IIa vs IIb) at any time point.

Conclusions:

  • CABG significantly improves LV systolic function in patients with severely depressed hemodynamics within one year.
  • The choice between CC and BC cardioplegia does not appear to influence the early or long-term hemodynamic outcomes of CABG.

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