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1.
Thorac Cardiovasc Surg ; 57(5): 276-80, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19629889

RESUMO

BACKGROUND: Atrial fibrillation (AF) is a common complication after coronary artery bypass grafting operation (CABG). Experimental data have shown antiarrhythmic effects of n-3 polyunsaturated fatty acids (PUFA) on myocardial cells. Orally administered PUFA could significantly reduce the rate of postoperative AF. We assessed the efficacy of PUFA for the prevention of AF after CABG. PUFA were given intravenously to prevent variation in bioavailability. METHODS AND RESULTS: 52 patients were randomized to the interventional group, 50 served as controls. In the control group free fatty acids (100 mg soya oil/kg body weight/day) were infused via perfusion pump, starting on admission to hospital and ending at discharge from intensive care. In the interventional group PUFA were given at a dosage of 100 mg fish oil/kg body weight/day. Primary end point was the postoperative development of AF, documented by surface ECG. Secondary end point was the length of stay in the ICU. The demographic, clinical and surgical characteristics of the patients in the two groups were similar. Postoperative AF occurred in 15 patients (30.6 %) in the control and in 9 (17.3 %) in the PUFA group ( P < 0.05). After CABG, the PUFA patients had to be treated in the ICU for a shorter time than the control patients. No adverse effects were observed. CONCLUSIONS: Perioperative intravenous infusion of PUFA reduces the incidence of AF after CABG and leads to a shorter stay in the ICU and in hospital. Our data suggest that perioperative intravenous infusion of PUFA should be recommended for patients undergoing CABG.


Assuntos
Antiarrítmicos/administração & dosagem , Fibrilação Atrial/prevenção & controle , Ponte de Artéria Coronária/efeitos adversos , Ácidos Graxos Ômega-3/administração & dosagem , Óleos de Peixe/administração & dosagem , Óleo de Soja/administração & dosagem , Idoso , Fibrilação Atrial/etiologia , Fibrilação Atrial/fisiopatologia , Cuidados Críticos , Método Duplo-Cego , Eletrocardiografia , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Infusões Intravenosas , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento
2.
Thorac Cardiovasc Surg ; 57(2): 79-84, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19241308

RESUMO

BACKGROUND: The effect of transmyocardial laser revascularization (TMLR) on microperfusion and oxygen supply was studied in an acute ischemia model, using 35 pigs, with 13 serving as controls. METHODS: Measurement of tissue oxygen tension was compared with the semiquantitative measurement of microperfusion using contrast echocardiography and infrared laser Doppler. All methods were used before and after coronary occlusion and after TMLR. Effects were measured in the ischemic area and in two ischemia independent areas. RESULTS: At baseline, oxygen partial pressure was 54.2 +/- 15.7 mmHg and decreased to 2.8 +/- 1.4 mmHg ( P < 0.05) after occlusion. After TMLR, oxygen tension increased to 27.3 +/- 8.5 mmHg ( P < 0.05) in the ischemic area, indicating a significant effect of TMLR on microperfusion and oxygen tension. Changes in regional oxygen tension corresponded to Levovist density changes in contrast echocardiography and changes in microperfusion measured by infrared laser Doppler. CONCLUSIONS: Our data indicate that measurement of tissue oxygen tension is a suitable experimental tool to assess the effect of TMLR on myocardial perfusion, which cannot be discriminated using clinical imaging methods.


Assuntos
Circulação Coronária , Eletroquímica , Terapia a Laser , Lasers de Excimer , Isquemia Miocárdica/cirurgia , Revascularização Miocárdica/métodos , Miocárdio/metabolismo , Oxigênio/metabolismo , Doença Aguda , Animais , Meios de Contraste , Modelos Animais de Doenças , Ecocardiografia/métodos , Eletroquímica/instrumentação , Eletrodos Seletivos de Íons , Fluxometria por Laser-Doppler , Masculino , Microcirculação , Isquemia Miocárdica/diagnóstico por imagem , Isquemia Miocárdica/metabolismo , Isquemia Miocárdica/fisiopatologia , Oxigênio/sangue , Pressão Parcial , Polissacarídeos , Reprodutibilidade dos Testes , Suínos
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