Assuntos
Fibrilação Atrial/prevenção & controle , Soluções Cardioplégicas/uso terapêutico , Doença da Artéria Coronariana/cirurgia , Sulfato de Magnésio/uso terapêutico , Complicações Pós-Operatórias/prevenção & controle , Soluções Cardioplégicas/administração & dosagem , Ponte de Artéria Coronária , Parada Cardíaca Induzida , Humanos , Sulfato de Magnésio/administração & dosagem , Resultado do TratamentoRESUMO
Combination of the primary congenital coronary artery anomalies, fistula and atherosclerosis rarely occur. We report a 50-year-old male who presented with severe chest pain, for which he underwent a coronary angiography. Injection into the right coronary artery (RCA) demonstrated a double RCA running very closely together in the atrioventricular groove. The superior one gave rise to a coronary fistula leading to the right ventricle and the inferior one was atherosclerotic. Both of them terminated as a posterior descending artery. The left system showed occlusion of the left anterior descending and major obtuse marginal. Both were corrected surgically.
Assuntos
Doença da Artéria Coronariana/epidemiologia , Anomalias dos Vasos Coronários/epidemiologia , Fístula/epidemiologia , Cardiopatias/epidemiologia , Comorbidade , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Ventrículos do Coração , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: The calcium-channel blocking effect of magnesium might have protective effects in patients undergoing cardiopulmonary bypass surgery. We assessed the effects of magnesium on hearts undergoing coronary artery bypass surgery with intermittent warm blood hyperkalemic cardioplegia in the antegrade fashion. PATIENTS AND METHODS: Twenty patients undergoing coronary bypass surgery were randomly divided into two groups, a control group who received intermittent antegrade warm blood hyperkalemic cardioplegia for myocardial protection, and a study group who received the same solution with the addition of magnesium to the cardioplegia. Extracellular substrates (creatinine phosphokinase, creatinine phosphokinase-MB group, lactate dehydrogenase, c-reactive protein, and cardiac troponin I were measured preoperatively and postoperatively. RESULTS: There were significant differences in the post-operative concentrations of creatinine phosphokinase, creatinine phosphokinase-MB group, c-reactive protein, and lactate dehydrogenase after cardiopulmonary bypass (P<0.001) in the study group compared with the control subjects. Cardiac troponin I levels were also significantly lower in the study group after cardiopulmonary bypass (P<0.005). CONCLUSIONS: Our study indicates that if magnesium is added to intermittent antegrade warm blood hyperkalemic cardioplegia, blood levels of many markers of cardiac myocardial injury after cardiopulmonary bypass are lowered. This finding may have implications for myocardial protection.
