Coronary grafts flow and cardiac pacing modalities: how to improve perioperative myocardial perfusion.

Hdl Handle:
http://hdl.handle.net/10147/208955
Title:
Coronary grafts flow and cardiac pacing modalities: how to improve perioperative myocardial perfusion.
Authors:
D'Ancona, Giuseppe; Hargrove, Martin; Hinchion, John; Ramesh, B C; Chughtai, Jehan Zeb; Anjum, Muhammad Nadeem; O'Donnell, Aonghus; Aherne, Tom
Affiliation:
Department of Cardiac Surgery, Cork University Hospital, Cork, Ireland., rgea@hotmail.com
Citation:
Eur J Cardiothorac Surg. 2004 Jul;26(1):85-8.
Journal:
European journal of cardio-thoracic surgery : official journal of the European, Association for Cardio-thoracic Surgery
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/208955
DOI:
10.1016/j.ejcts.2004.03.042
PubMed ID:
15200984
Abstract:
OBJECTIVE: Aim of this study was to investigate modifications of coronary grafts flow during different pacing modalities after CABG. MATERIALS AND METHODS: Two separate prospective studies were conducted in patients undergoing CABG and requiring intraoperative epicardial pacing. In a first study (22 patients) coronary grafts flows were measured during dual chamber pacing (DDD) and during ventricular pacing (VVI). In a second study (10 patients) flows were measured during DDD pacing at different atrio-ventricular (A-V) delay periods. A-V delay was adjusted in 25 ms increments from 25 to 250 ms and flow measurements were performed for each A-V delay increment. A transit time flowmeter was used for the measurements. RESULTS: An average of 3.4 grafts/patient were performed. In the first study, average coronary graft flow was 47.4+/-20.8 ml/min during DDD pacing and 41.8+/-18.2 ml/min during VVI pacing (P = 0.0004). Furthermore average systolic pressure was 94.3+/-10.1 mmHg during DDD pacing and 89.6+/-12.2 mmHg during VVV pacing (P = 0.0007). No significant differences in diastolic pressure were recorded during the two different pacing modalities. In the second study, maximal flows were achieved during DDD pacing with an A-V delay of 175 ms (54+/-9.6 ml/min) and minimal flows were detected at 25 ms A-V delay (38.1+/-4.7 ml/min) (P=ns). No significant differences in systolic or diastolic blood pressure were noticed during the different A-V delays. CONCLUSION: Grafts flowmetry provides an extra tool to direct supportive measures such as cardiac pacing after CABG. DDD mode with A-V delay around 175 ms. should be preferred to allow for maximal myocardial perfusion via the grafts.
Language:
eng
MeSH:
Cardiac Pacing, Artificial/*methods; Coronary Artery Bypass/*methods; *Coronary Circulation; Hemodynamics; Humans; Intraoperative Care/*methods; Prospective Studies; *Vascular Patency
ISSN:
1010-7940 (Print); 1010-7940 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorD'Ancona, Giuseppeen_GB
dc.contributor.authorHargrove, Martinen_GB
dc.contributor.authorHinchion, Johnen_GB
dc.contributor.authorRamesh, B Cen_GB
dc.contributor.authorChughtai, Jehan Zeben_GB
dc.contributor.authorAnjum, Muhammad Nadeemen_GB
dc.contributor.authorO'Donnell, Aonghusen_GB
dc.contributor.authorAherne, Tomen_GB
dc.date.accessioned2012-02-03T15:08:24Z-
dc.date.available2012-02-03T15:08:24Z-
dc.date.issued2012-02-03T15:08:24Z-
dc.identifier.citationEur J Cardiothorac Surg. 2004 Jul;26(1):85-8.en_GB
dc.identifier.issn1010-7940 (Print)en_GB
dc.identifier.issn1010-7940 (Linking)en_GB
dc.identifier.pmid15200984en_GB
dc.identifier.doi10.1016/j.ejcts.2004.03.042en_GB
dc.identifier.urihttp://hdl.handle.net/10147/208955-
dc.description.abstractOBJECTIVE: Aim of this study was to investigate modifications of coronary grafts flow during different pacing modalities after CABG. MATERIALS AND METHODS: Two separate prospective studies were conducted in patients undergoing CABG and requiring intraoperative epicardial pacing. In a first study (22 patients) coronary grafts flows were measured during dual chamber pacing (DDD) and during ventricular pacing (VVI). In a second study (10 patients) flows were measured during DDD pacing at different atrio-ventricular (A-V) delay periods. A-V delay was adjusted in 25 ms increments from 25 to 250 ms and flow measurements were performed for each A-V delay increment. A transit time flowmeter was used for the measurements. RESULTS: An average of 3.4 grafts/patient were performed. In the first study, average coronary graft flow was 47.4+/-20.8 ml/min during DDD pacing and 41.8+/-18.2 ml/min during VVI pacing (P = 0.0004). Furthermore average systolic pressure was 94.3+/-10.1 mmHg during DDD pacing and 89.6+/-12.2 mmHg during VVV pacing (P = 0.0007). No significant differences in diastolic pressure were recorded during the two different pacing modalities. In the second study, maximal flows were achieved during DDD pacing with an A-V delay of 175 ms (54+/-9.6 ml/min) and minimal flows were detected at 25 ms A-V delay (38.1+/-4.7 ml/min) (P=ns). No significant differences in systolic or diastolic blood pressure were noticed during the different A-V delays. CONCLUSION: Grafts flowmetry provides an extra tool to direct supportive measures such as cardiac pacing after CABG. DDD mode with A-V delay around 175 ms. should be preferred to allow for maximal myocardial perfusion via the grafts.en_GB
dc.language.isoengen_GB
dc.subject.meshCardiac Pacing, Artificial/*methodsen_GB
dc.subject.meshCoronary Artery Bypass/*methodsen_GB
dc.subject.mesh*Coronary Circulationen_GB
dc.subject.meshHemodynamicsen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIntraoperative Care/*methodsen_GB
dc.subject.meshProspective Studiesen_GB
dc.subject.mesh*Vascular Patencyen_GB
dc.titleCoronary grafts flow and cardiac pacing modalities: how to improve perioperative myocardial perfusion.en_GB
dc.contributor.departmentDepartment of Cardiac Surgery, Cork University Hospital, Cork, Ireland., rgea@hotmail.comen_GB
dc.identifier.journalEuropean journal of cardio-thoracic surgery : official journal of the European, Association for Cardio-thoracic Surgeryen_GB
dc.description.provinceMunster-

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