1. Changes of biventricular function after CABG surgery: does cardioplegia type matter?
- Author
-
Edmundas Širvinskas, Tadas Lenkutis, Eglė Ereminienė, Agnė Abramavičiūtė, Ramūnas Unikas, Rasa Ordienė, Povilas Jakuška, and Rimantas Benetis
- Subjects
Advanced and Specialized Nursing ,medicine.medical_specialty ,Systole ,business.industry ,General Medicine ,Cabg surgery ,030204 cardiovascular system & hematology ,Ventricular Function, Left ,Biventricular function ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Echocardiography ,Internal medicine ,Heart Arrest, Induced ,Cardiology ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Blood cardioplegia ,Coronary Artery Bypass ,Cardiology and Cardiovascular Medicine ,business ,Safety Research - Abstract
Aim: we choose to evaluate, whether type of cardioplegia is an important predictor to determine biventricular function changes after CABG. Methods: 81 patients who underwent CABG surgery and matched inclusion criteria were enrolled in this study. The exclusion criteria were acute MI within 30 days, impaired systolic left ventricle function (LVEF ⩽35%), atrial fibrillation.TTE was performed for all patients and echocardiographic parameters of biventricular geometry and function were assessed before CABG surgery, first postoperative day and 6 months after surgery. Cardioplegia type was randomly chosen. First group consisted of 49 patients (60.5%) when CC was performed and the others 32 patients (39.5%) formed the second - BC group. Results: Patients’ demographic characteristics were similar in both groups, except the lower rates of AH and BSA in BC group ( p = 0.015, p = 0.001 respectively). Longer duration of XCT and CBP time was observed in BC group (p = 0.019 and p = 0.028). BC group patients showed more efficient right heart chambers size reduction ( p = 0.001 for RV diameter; p = 0.015 for RA diameter) and better improvement of longitudinal RV function ( p = 0.02 for TAPSE; p = 0.001 for RV S’) 6 months after surgery when compared with CC group patients. RV global systolic function diminished in both groups postoperatively, but the reduction was higher in CC group, although the difference was significant in comparing early postoperative measurements with the late after CABG surgery ( p = 0.03). Changes of LV systolic function as well as diameter of LA did not differ between groups ( p = 0.165 and p = 0.279, respectively), while diastolic function improved significantly in BC group patients at the late follow-up period: E/e’ decreased (p Conclusion: BC is associated with better RV reverse remodelling and improvement of longitudinal RV function, as well as LV diastolic function improvement after CABG surgery.
- Published
- 2020