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Objective:To investigate the effect of L-carnitine on myocardial ischemia-reperfusion injury in patients undergoing coronary artery bypass grafting (CABG) operation.Methods:The clinical data of 60 patients who had underwent CABG under extracorporeal circulation in Department of Cardiovascular Surgery, the First Affiliated Hospital of Medical College of Xi′an Jiaotong University from January 2015 to December 2017 was retrospectively analyzed. L-carnitine was infused into the patients in the observation group while the equal amount of normal saline was given to the patients in the control group during perioperative period. Venous blood was collected from each patient 1 hour before the surgery and at 2, 6, 24 and 72 hours after unclamping the aorta, then serum levels of aspartate aminotransferase (AST), lactic acid dehydrogenase (LDH), creatine kinase (CK), and creatine kinase-MB isozyme (CK-MB) were detected. Additionally, cardiac function indices including stroke volume (SV), left ventricular diastolic diameter (LVDD), cardiac output (CO), Left ventricular ejection fraction (lVEF) were compared between the two group patients before the surgery and 6 days after operation.Results:Compared with before the operation, the levels of serum enzymes were all significantly increased after unclamping the aorta. The levels of serum AST, LDH and CK reached their peak at 24 hours after unclamping the aorta. Notably, the levels of serum AST, LDH and CK in the experimental group were lower than that in the control group at each time point after unclamping the aorta ( P<0.05). For serum CK-MB, the level in the experimental group reached its peak at 6 hours after unclamping the aorta, while the peak value was observed at 24 hours after unclamping the aorta in the control group. The level of CK-MB in the experimental group was significantly decreased compared with the control group at each time point after unclamping the aorta ( P<0.05). Moreover, there were no significant differences in cardiac function indices between the 2 groups before the operation ( P>0.05). The levels of SV, CO and LVEF in the experimental group were significantly increased while the level of LVDD was obviously decreased compared to that in the control group after the operation ( P<0.05). Conclusions:L-carnitine has protective effects on myocardial ischemia-reperfusion injury in patients undergoing CABG operation under cardiopulmonary bypass, with reducing serum levels of myocardial enzyme in these patients.
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Objective To investigate the difference of curative effects and prognosis between coronary artery bypass grafting with and without cardiopulmonary bypass.Methods 152 patients who were operated using off-pump coronary artery bypass grafting (OPCABG) and 107 patients who were performed with on-pump coronary artery bypass grafting (CABG) in the authors'department during the period from October 2013 to October 2017 were included in the study.The differences of postoperative recovery and major complications between the two groups were analyzed.Results Compared with CABG group,patients in OPCABG group had shorter intensive care unit (ICU) monitoring time,electrocardio-monitoring time,duration of antibiotic treatment,time of drainage tube intubation,mechanical ventilation time,arterial piezometer tube monitoring time and length of hospital stay (P ＜ 0.05).And postoperative draining fluid volume in patients of OPCABG group was also less than that in CABG group (P ＜ 0.05).Additionally,there was no difference between the two groups in postoperative parameters including renal insufficiency,using intra-aortic balloon pump (IABP) machine,perioperative myocardial infarction,second operation for hemorrhage,the occurrence of postoperative arrhythmias and cerebrovascular accident (P ＞ 0.05).However,the incidence of postoperative pulmonary infection was significantly higher in patients of CABG group than that in OPCABG group (P ＜ 0.05).Conclusions The incidence of postoperative pulmonary infection was significantly decreased in OPCABG group compared with that in CABG group.And the postoperative recovery of patients undergoing off-pump coronary artery bypass grafting was superior to that of patients undergoing onpump coronary artery bypass grafting.
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Objective@#To investigate the effect of Calcium dibutyryladenosine cyclophosphate on myocardial ischemia-reperfusion injury in patients undergoing coronary artery bypass grafting (CABG) operation.@*Methods@#The clinical data of 62cases were retrospectively analyzed. These patients were performed coronary artery bypass graft (CABG) operation under cardiopulmonary bypass (CPB) in the First Affiliated Hospital of Medical College of Xi′an Jiaotong University from January 2013 to January 2016. According to the use calcium dibutyryladenosine cyclophosphate, 62 patients were divided into the control group and the experimental group. Thirty-one cases in the experimental group were given an intravenous drip of calcium dibutyryladenosine cyclophosphate, while other 31 cases in the control group were not given to calcium dibutyryladenosine cyclophosphate during perioperative period. Venous blood was collected from each patient 1 h before the surgery and 2, 6, 24 and 72 h after unclamping the aorta, then serum levels of aspartate aminotransferase (AST), lactic acid dehydrogenase (LDH), creatine kinase (CK), and creatine kinase-MB isozyme (CK-MB) were detected. Additionally, cardiac function indices including SV, LVDD, CO, LVEF in these patients were recorded before the operation and 6 days after operation.@*Results@#Compared with those before the operation, the levels of serum enzymes were all significantly increased after unclamping the aorta. The levels of serum AST, LDH and CK reached their peak 24 h after unclamping the aorta. Notably, the levels of serum AST, LDH and CK in the experimental group were lower than those in the control group at each time point after unclamping the aorta (P < 0.05). For serum CK-MB, the level in both the two groups reached its peak 6 h after unclamping the aorta. The level of CK-MB in the experimental group was significantly decreased compared with that in the control group 6, 24 and 72 h after unclamping the aorta (P < 0.05). Moreover, there were no significant differences in cardiac function indices between the 2 groups before the operation (P > 0.05). The levels of SV, CO and LVEF in the experimental group were significantly increased while the level of LVDD was obviously decreased compared to that in the control group after the operation, SV: (70.93 ± 9.72) ml vs. (65.07 ± 6.81) ml, CO: (5.32 ± 0.98) L vs. (4.29 ± 0.91) L, LVEF: (57.87 ± 8.92)% vs. (52.68 ± 7.31)% and LVDD: (55.67 ± 4.12) mm vs. (62.85 ± 5.71) mm, and there were statistical differences (P < 0.05).@*Conclusions@#Calcium dibutyryladenosine cyclophosphate has protective effects on myocardial ischemia-reperfusion injury and cardiac function in patients undergoing CABG operation under CPB, by reducing serum levels of myocardial enzymes in these patients.
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Objective To investigate the effect of intravenous drip of levocarnitine during perioperative period on serum cytokines and cardiac troponin (cTn) I in patients undergoing coronary artery bypass grafting (CABG) under extracorporeal circulation. Methods The clinical data of 70 patients who had underwent CABG under extracorporeal circulation in Department of Cardiovascular Surgery, the First Affiliated Hospital of Medical College of Xi′an Jiaotong University from January 2015 to December 2017 were retrospectively analyzed. Among them, 35 cases were treated with intravenous infusion of levocarnitine (experiment group), and 35 cases were not treated with intravenous infusion of levocarnitine (control group). The serum levels of cTnI, tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8 and IL-10 1 h before operation and 2, 6, 24, 72 h after aorta open were detected; the postoperative recovery and complication were recorded. Results There were no statistical differences in TNF-α, IL-6, IL-8, IL-10 and cTnI before operation between 2 groups (P＞0.05); the indexes 2, 6, 24 and 72 h after aorta open were significantly higher than those before operation, and there were statistical differences (P＜0.05). The TNF-α, IL-6 and cTnI 2, 6, 24 and 72 h after aorta open in experiment group were significantly lower than those in control group, and the IL-10 was significantly higher than that in control group; the IL-8 2, 6 and 24 h after aorta open in experiment group were significantly lower than that in control group, and there were statistical differences (P＜0.05). The ICU monitoring time, electrocardio-monitoring time, duration of antibiotic treatment, duration of drainage tube, mechanical ventilation time and length of hospital stay in experiment group were significantly shorter than those in control group: (2.9 ± 0.5) d vs. (3.5 ± 0.8) d, (5.7 ± 1.8) d vs. (7.6 ± 3.2) d, (6.7 ± 1.5) d vs. (9.8 ± 2.2) d, (3.1 ± 0.8) d vs. (3.9 ± 1.4) d, (3.3 ± 2.1) d vs. (5.1 ± 2.3) d and (8.1 ± 2.2) d vs. (12.8 ± 2.6) d, and there were statistical differences (P＜0.01). Moreover, there were no severe perioperative complications such as myocardial infarction and pulmonary infection in 2 groups. Conclusions Intravenous drip of levocarnitine during perioperative period could effectively control postoperative inflammatory response and myocardial injury in patients undergoing CABG under extracorporeal circulation. The effect of levocarnitine may be related to its ability to balance the levels between proinflammatory cytokines and anti-inflammatory cytokines.
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ObjectiveTo summarize the one-year follow-up clinical result of patients undergoing Endoscopic vein harvest (EVH) technology to collect greater saphenous vein( GSV )in coronary artery bypass operation (CABG),and to assess the related factors influencing the outcome.Methods248 patients underwent off-pump coronary artery bypass grafting (OPCAG) from May 2009 to May 2010.Among these patients,136 patients with coronary artery disease received EVH technology to gain GSV,and 112 patients received conventional open vein harvesting (OVH).Then 71 EVH (group 1 ) patients and 64 OVH ( group 2 ) patients had one-year follow-up analysis.We compared and evaluated the data of two groups about operation information,lower limb wound complication,bridge blood vessels patency rate,and psychologic status.ResultsThe date of wound surface size,wound healing and appearance,wound infection rate,the second debridement rate and the overall lower limb wound complication rate show that EVH was better than OVH.After one-year follow-up,we contrasted the patency rate of bridge blood vessels between two groups.The patency rate of arterial bridge blood vessels was 96.8％ ( venous bridge blood vessels was 85.7％ )in group of EVH when we followed up 63 patients;while the patency rate of arterial bridge blood vessels was 94.9％ ( venous bridge blood vessels was 86.4％ ) in group of OVH that we followed up 59 patients.We compared the outcome between two groups,and found that there were no statistical significance in angina recurrence rate,patency rate of venous graft and patency rate of arterial graft.But the psychologic status was different,the EVH group was better than OVH group.ConclusionCompared to OVH,EVH technique has more advantages.Through taking a more secure method in the collection process of the bridging vein material,EVH group also maintained a satisfactory one-year graft patency rate.