■在体外循环冠状动脉旁路移植术(ONCAB)期间,用于远端吻合测试的移植物冲洗也会灌注下游心肌。这项单中心回顾性研究评估了在ONCAB期间特定保存溶液对心肌保护的影响。
■在2019年7月至2020年3月期间,将DuraGraft(DG)或0.9%盐水/Biseko(SB)应用于272ONCAB。总的来说,166例患者按倾向匹配分为两组。术后7天评估心肌酶[高敏肌钙蛋白I(hs-TnI)和肌酸激酶(CK)]。
■手术后,在DG组中,hs-TnI值在3至6h(h)至4天之间显着降低:3-6h:4,034ng/L[IQR1,853-8,654]vs.5,532ng/L[IQR3,633-8,862],p=0.05;12-24小时:2,420ng/L[IQR1,408-5,782]vs.4,166[IQR2,052-8,624],p<0.01;2天:1,095ng/L[IQR479-2,311]vs.1,564纳克/升[IQR659-5,057],p=0.02和4天:488ng/L[IQR232-1,061]vs.745纳克/升[IQR319-1,820],p=0.03。最大值:4,151ng/L[IQR2,056-8,621]vs.6,349纳克/升[IQR4,061-12,664],p<0.01,曲线下面积中位数(AUC):6,146ng/L/24h[IQR3,121-13,248]vs.10,735纳克/升/24小时[IQR4,859-21,484],p=0.02在DG组中较低。组间CK值无显著差异:最大值690[IQR417-947]vs.631[464-979],p=0.61和AUC1,986[1,226-2,899]vs.2,081[1,311-3,063],p=0.37。
■用DG反复冲洗移植物导致术后肌钙蛋白值较低,表明与SB相比心肌保护增强。需要进行其他研究以进一步评估DG的心肌保护特性。
UNASSIGNED: During on-pump coronary artery bypass grafting (ONCAB), graft flushing for distal anastomoses testing also perfuses the downstream myocardium. This single-center retrospective study evaluated the impact of specific preservation solutions on myocardial protection during ONCAB.
UNASSIGNED: Between July 2019 and March 2020 either DuraGraft (DG) or 0.9% Saline/Biseko (SB) was applied to 272 ONCAB. Overall, 166 patients were propensity-matched into two groups. Cardiac enzymes [high-sensitive Troponin I (hs-TnI) and creatine kinase (CK)] were evaluated 7 days post-surgery.
UNASSIGNED: Post-surgery, hs-TnI values were significantly lower from 3 to 6 h (h) up to 4 days in the DG group: 3-6 h: 4,034 ng/L [IQR 1,853-8,654] vs. 5,532 ng/L [IQR 3,633-8,862], p = 0.05; 12-24 h: 2,420 ng/L [IQR 1,408-5,782] vs. 4,166 [IQR 2,052-8,624], p < 0.01; 2 days: 1,095 ng/L [IQR 479-2,311] vs. 1,564 ng/L [IQR 659-5,057], p = 0.02 and at 4 days: 488 ng/L [IQR 232-1,061] vs. 745 ng/L [IQR 319-1,820], p = 0.03. The maximum value: 4,151 ng/L [IQR 2,056-8,621] vs. 6,349 ng/L [IQR 4,061-12,664], p < 0.01 and the median area under the curve (AUC): 6,146 ng/L/24 h [IQR 3,121-13,248] vs. 10,735 ng/L/24 h [IQR 4,859-21,484], p = 0.02 were lower in the DG group. CK values were not significantly different between groups: maximum value 690 [IQR 417-947] vs. 631 [464-979], p = 0.61 and AUC 1,986 [1,226-2,899] vs. 2,081 [1,311-3,063], p = 0.37.
UNASSIGNED: Repeated graft flushing with DG resulted in lower Troponin values post-surgery suggesting enhanced myocardial protection compared to SB. Additional studies are warranted to further assess the myocardial protection properties of DG.