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Prostacyclin Reduces Incidence of Myocardial Damage After Coronary Endarterectomy  Z̆ivojin S. Jonjev, MD, Svetozar Nićin, MD, Vujadin Mujović, MD, Ljuborad.

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Presentation on theme: "Prostacyclin Reduces Incidence of Myocardial Damage After Coronary Endarterectomy  Z̆ivojin S. Jonjev, MD, Svetozar Nićin, MD, Vujadin Mujović, MD, Ljuborad."— Presentation transcript:

1 Prostacyclin Reduces Incidence of Myocardial Damage After Coronary Endarterectomy 
Z̆ivojin S. Jonjev, MD, Svetozar Nićin, MD, Vujadin Mujović, MD, Ljuborad Petrović, MD, Ninoslav Radovanović, MD  The Annals of Thoracic Surgery  Volume 78, Issue 4, Pages (October 2004) DOI: /j.athoracsur

2 Fig 1 Protocol for myocardial protection during open-heart surgical procedures. The procedure is based on the physiologic approach to cardioprotection, owing to adjustment of recovery of the “steady state” during cardiopulmonary bypass. In addition to catecholamine and nitroglycerin, prostacyclin was added to the protocol to achieve inotropic, vasodilatory, cytoprotective, and antiaggregatory effect. (Ao = aorta; BW = body weight; Ca = calcium; ECC = extracorporeal circulation; H = hours; Hc = hematocrit; min = minutes; POSTOP. = postoperative; T = temperature.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )

3 Fig 2 Protocol for antiaggregatory and anticoagulation therapy for endarterectomized coronary patients. Heparin was started after opening the pericardial sac and was neutralized with protamine at the end of extracorporeal circulation in a 1:1 ratio. Prostacyclin infusion was started 10 to 15 minutes before the removal of the cross clamp, or at the time of rewarming. Prostacyclin infusion was continued for the first 24 hours after operation. Heparin was usually started 24 hours after the surgery, and was replaced with coumadin after the normalization of the thrombin and partial thromboplastin time. (BW = body weight; ECC = extracorporeal circulation; h = hours; min = minutes.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )

4 Fig 3 Endarterectomized core after triple coronary endarterectomy.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )

5 Fig 4 Release of creatine kinase-MB (CK-MB) isozyme over time in endarterectomized patients after surgery. Significantly lower levels of CK-MB isozyme in the prostacyclin group (triangles) suggested a possible lower level of myofilament degradation during cardioplegic arrest. Circles = control group. *Value of p for time (p < 0.001). †Value of p for group interaction (p < 0.001). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )

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