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Article: Endothelial effects of hemostatic devices for continuous cardioplegia or minimally invasive operations

TitleEndothelial effects of hemostatic devices for continuous cardioplegia or minimally invasive operations
Authors
Issue Date1996
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/athoracsur
Citation
Annals Of Thoracic Surgery, 1996, v. 62 n. 4, p. 1158-1163 How to Cite?
AbstractBackground. Improvements in myocardial protection may include the continuous delivery of normothermic blood cardioplegia. Technical aids are required for optimal visualization of the operative field during the performance of coronary anastomoses if cardioplegia is to be given continuously or during minimally invasive operations. However, the effects of the different hemostatic devices on coronary endothelial function are unknown. Methods. We compared the effects on endothelial function of two commonly used hemostatic techniques, coronary clamping and gas jet insufflation, with those of a technique using extravascular balloon occlusion to mimic systolic luminal closure by the surrounding myocardium. The three techniques were applied for 15 minutes on porcine epicardial coronary arteries from explanted hearts. For coronary clamping, standard bulldog clamps were used. Gas jet insufflation was applied by blowing oxygen (12 L/min) tangentially at a 45-degree angle 1 cm away from a 3-mm arteriotomy. Extravascular balloon occlusion was achieved with a needle-tipped silicone loop, the midportion of which, once positioned beneath the coronary artery, was inflated to push a myocardial 'cushion' against the back of the vessel until its occlusion. Control rings were taken from the same coronary artery. The endothelial function of control and instrumented arterial rings was then studied in organ chambers filled with modified Krebs-Ringer bicarbonate solution. Results. Contractions to potassium chloride and prostaglandin F(2α) and endothelium-independent relaxation to sin-1, a nitric oxide donor, were unaffected in all groups. Endothelium-dependent relaxation to serotonin was impaired after clamping and preserved after gas jet insufflation and extravascular balloon occlusion. Maximal endothelium-dependent relaxation to serotonin was as follows: for coronary clamping, 63% ± 6% versus 87% ± 3% in controls; for gas jet insufflation, 67% ± 12% versus 88% ± 7%; and for extraluminal balloon occlusion, 79% ± 6% versus 85% ± 5%. Conclusions: Whereas commonly used hemostatic devices may impair endothelial function, extravascular balloon occlusion appears to achieve effective hemostasis while preserving endothelial integrity.
Persistent Identifierhttp://hdl.handle.net/10722/171192
ISSN
2015 Impact Factor: 2.975
2015 SCImago Journal Rankings: 1.490
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorPerrault, LPen_US
dc.contributor.authorMenasché, Pen_US
dc.contributor.authorWassef, Men_US
dc.contributor.authorBidouard, JPen_US
dc.contributor.authorJaniak, Pen_US
dc.contributor.authorVilleneuve, Nen_US
dc.contributor.authorJacquemin, Cen_US
dc.contributor.authorBloch, Gen_US
dc.contributor.authorVilaine, JPen_US
dc.contributor.authorVanhoutte, PMen_US
dc.date.accessioned2012-10-30T06:12:37Z-
dc.date.available2012-10-30T06:12:37Z-
dc.date.issued1996en_US
dc.identifier.citationAnnals Of Thoracic Surgery, 1996, v. 62 n. 4, p. 1158-1163en_US
dc.identifier.issn0003-4975en_US
dc.identifier.urihttp://hdl.handle.net/10722/171192-
dc.description.abstractBackground. Improvements in myocardial protection may include the continuous delivery of normothermic blood cardioplegia. Technical aids are required for optimal visualization of the operative field during the performance of coronary anastomoses if cardioplegia is to be given continuously or during minimally invasive operations. However, the effects of the different hemostatic devices on coronary endothelial function are unknown. Methods. We compared the effects on endothelial function of two commonly used hemostatic techniques, coronary clamping and gas jet insufflation, with those of a technique using extravascular balloon occlusion to mimic systolic luminal closure by the surrounding myocardium. The three techniques were applied for 15 minutes on porcine epicardial coronary arteries from explanted hearts. For coronary clamping, standard bulldog clamps were used. Gas jet insufflation was applied by blowing oxygen (12 L/min) tangentially at a 45-degree angle 1 cm away from a 3-mm arteriotomy. Extravascular balloon occlusion was achieved with a needle-tipped silicone loop, the midportion of which, once positioned beneath the coronary artery, was inflated to push a myocardial 'cushion' against the back of the vessel until its occlusion. Control rings were taken from the same coronary artery. The endothelial function of control and instrumented arterial rings was then studied in organ chambers filled with modified Krebs-Ringer bicarbonate solution. Results. Contractions to potassium chloride and prostaglandin F(2α) and endothelium-independent relaxation to sin-1, a nitric oxide donor, were unaffected in all groups. Endothelium-dependent relaxation to serotonin was impaired after clamping and preserved after gas jet insufflation and extravascular balloon occlusion. Maximal endothelium-dependent relaxation to serotonin was as follows: for coronary clamping, 63% ± 6% versus 87% ± 3% in controls; for gas jet insufflation, 67% ± 12% versus 88% ± 7%; and for extraluminal balloon occlusion, 79% ± 6% versus 85% ± 5%. Conclusions: Whereas commonly used hemostatic devices may impair endothelial function, extravascular balloon occlusion appears to achieve effective hemostasis while preserving endothelial integrity.en_US
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/athoracsuren_US
dc.relation.ispartofAnnals of Thoracic Surgeryen_US
dc.subject.meshAnimalsen_US
dc.subject.meshBalloon Dilation - Instrumentationen_US
dc.subject.meshConstrictionen_US
dc.subject.meshCoronary Vessels - Pathology - Physiologyen_US
dc.subject.meshDinoprost - Pharmacologyen_US
dc.subject.meshEndothelium, Vascular - Pathology - Physiologyen_US
dc.subject.meshHeart Arrest, Induceden_US
dc.subject.meshHemostasis, Surgical - Adverse Effects - Instrumentationen_US
dc.subject.meshMolsidomine - Analogs & Derivatives - Pharmacologyen_US
dc.subject.meshMyocardial Revascularizationen_US
dc.subject.meshPotassium Chloride - Pharmacologyen_US
dc.subject.meshSerotonin - Pharmacologyen_US
dc.subject.meshSurgical Instruments - Adverse Effectsen_US
dc.subject.meshSurgical Procedures, Minimally Invasiveen_US
dc.subject.meshSwineen_US
dc.subject.meshVasoconstriction - Drug Effectsen_US
dc.subject.meshVasodilator Agents - Pharmacologyen_US
dc.titleEndothelial effects of hemostatic devices for continuous cardioplegia or minimally invasive operationsen_US
dc.typeArticleen_US
dc.identifier.emailVanhoutte, PM:vanhoutt@hku.hken_US
dc.identifier.authorityVanhoutte, PM=rp00238en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/0003-4975(96)00536-Xen_US
dc.identifier.pmid8823106-
dc.identifier.scopuseid_2-s2.0-0030272428en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0030272428&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume62en_US
dc.identifier.issue4en_US
dc.identifier.spage1158en_US
dc.identifier.epage1163en_US
dc.identifier.isiWOS:A1996VK87400050-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridPerrault, LP=7004370552en_US
dc.identifier.scopusauthoridMenasché, P=7102635294en_US
dc.identifier.scopusauthoridWassef, M=7006493556en_US
dc.identifier.scopusauthoridBidouard, JP=6601955808en_US
dc.identifier.scopusauthoridJaniak, P=6603686655en_US
dc.identifier.scopusauthoridVilleneuve, N=7003458215en_US
dc.identifier.scopusauthoridJacquemin, C=7004759803en_US
dc.identifier.scopusauthoridBloch, G=7005864339en_US
dc.identifier.scopusauthoridVilaine, JP=7004617134en_US
dc.identifier.scopusauthoridVanhoutte, PM=7202304247en_US

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