The Annals of thoracic surgery
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Randomized Controlled Trial Comparative Study Clinical Trial
A prospective randomized study to evaluate stress response during beating-heart and conventional coronary revascularization.
Cardiopulmonary bypass (CPB) is associated with a systemic stress hormonal response, which can lead to changes in hemodynamics and organ perfusion. We examined perioperative stress hormone release in low-risk patients undergoing coronary artery bypass grafting with and without cardiopulmonary bypass. ⋯ Despite the avoidance of cardiopulmonary bypass, off-pump coronary artery bypass grafting surgery triggers a systemic stress hormone response that is comparable to conventional surgical revascularization. The neurohormonal environment during beating-heart surgery should be further explored.
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Randomized Controlled Trial Comparative Study Clinical Trial
Bradykinin preconditioning in coronary artery bypass grafting.
Experimental studies have shown that activation of bradykinin B2 receptor is one of the most important triggers of ischemic preconditioning. However, the effect of exogenous administration of bradykinin in cardiac surgery is not yet known. The present prospective randomized study was designed to investigate the effect of bradykinin pretreatment in patients undergoing elective coronary artery bypass surgery. ⋯ Exogenous bradykinin infusion showed weak cardioprotective effect in the low-risk patients undergoing coronary artery bypass surgery but the dose used in the study caused acute decrease of systemic blood pressure.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of leukocyte depletion on endothelial cell activation and transendothelial migration of leukocytes during cardiopulmonary bypass.
Although leukocyte depletion from systemic circulation during cardiopulmonary bypass (CPB) has been studied, the effect of leukocyte depletion on the leukocyte-endothelial cascade remains poorly understood. So far, there has been no published work on the effects of leukocyte filters during cardiac operations from the viewpoint of endothelial activation and transendothelial neutrophil migration. ⋯ Our results demonstrate a rationale for using a leukocyte filter in patients undergoing cardiac surgery to attenuate the endothelial-mediated component of the CPB-induced inflammatory response by reducing endothelial activation and neutrophil transmigration.