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- W2318862007 abstract "Objectives: Lack of perfusion during vein harvesting, leading to graft ischaemia, and disruption of the endothelial layer, created by mechanical trauma and manual distension, are the two main causes of vein graft failure. At the time of harvesting, vein grafts are routinely distended with normal saline to overcome spasm. An important cause of graft failure is the trauma on the graft caused by this distension. Indeed, high pressure can damage endothelial cells, even when we use blood in lieu of crystalloid solutions. We therefore sought to reduce graft ischaemia and avoid distension by maintaining blood flow into vein grafts throughout surgery at low cost and without the use of special devices. Methods: After pericardiotomy, the ascending aorta is cannulated with a cardioplegic cannula, which is subsequently extended to the vein graft. Throughout harvesting and until distal end anastomosis, vein infusion with oxygenated blood is maintained. After each distal anastomosis is performed, the coronary bed is also infused with the side branch of the same cannula. Results: We used this method in 300 cases of off-pump coronary artery bypass grafting (CABG). Early results in terms of myocardial function during manipulation seem promising. Also, there was a reduction in the need for conversion to cardiopulmonary bypass as well as in ST/T changes and cardiac enzyme elevation in comparison to routine off-pump CABG. Conclusions: This technique confers favourable myocardial function and protection in the presence of left ventricular dysfunction, especially in elderly patients." @default.
- W2318862007 created "2016-06-24" @default.
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- W2318862007 date "2013-09-18" @default.
- W2318862007 modified "2023-09-27" @default.
- W2318862007 title "009-I * CONTINUOUS PERFUSION OF SAPHENOUS VEIN BY OXYGENATED BLOOD DURING BEATING HEART CORONARY SURGERY" @default.
- W2318862007 doi "https://doi.org/10.1093/icvts/ivt372.9" @default.
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