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17. Aortenklappeninsuffizienz.

Author

Seitelberger, R., Steindl, J., and Dinges, C.

Abstract

Copyright of Zeitschrift für Herz-, Thorax- und Gefaesschirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2019
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30. Perioperative infusion of nifedipine and metoprolol provides antiischemic and antiarrhythmic protection in patients undergoing elective aortocoronary by-pass surgery

Author

Bruno Podesser, Schwarzacher, S., Zwolfer, W., Binder, T., Spatt, J., Peschl, F., Huber, S., Wolner, E., and Seitelberger, R.

Subjects
Intraoperative Care, Time Factors, Nifedipine, Myocardial Ischemia, Arrhythmias, Cardiac, Endarterectomy, Isoenzymes, Heart Rate, Electrocardiography, Ambulatory, Humans, Coronary Artery Bypass, Infusions, Intravenous, Intraoperative Complications, Creatine Kinase, Metoprolol
Abstract

A randomised study was performed on 70 patients undergoing elective coronary by-pass procedure to examine whether the combined, perioperative, 24-hour infusion of nifedipine and metoprolol reduces the incidence of perioperative myocardial ischemia and arrhythmias. The control group received nifedipine only. Repeated assessments of serum enzyme levels and 12-lead-ECG together with a 3-channel Holter monitoring over 48h were used to classify perioperative myocardial ischemia and supraventricular and ventricular arrhythmias. The two groups did not differ with respect to their demographic data, extracorporeal circulation, aortic cross-clamping time, or number of distal anastomosis. No perioperative myocardial infarction in either group was detected. However, a significantly lower incidence of transient ischemic event was observed in the NM group as compared transient ischemic events was observed in the NM group as compared to the N group. In addition, there was a tendency towards lower CK-MB-level and peak-values of CK- and CK-MB-enzymes in the NM group. With regard to perioperative dysrhythmias, there was a significantly lower incidence of sinus tachycardia and atrial flutter/fibrillation in the NM group as compared to the N group. In addition, postoperative heart rate was lower in the NM group starting from the 6th hour after opening the aortic cross-clamp. In conclusion, the combined perioperative infusion of nifedipine and metoprolol is superior in preventing perioperative myocardial ischemia and decreasing the incidence of supraventricular arrhythmias as compared to a single-drug regimen with nifedipine.

Published
1994

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