Effects of Cross-Clamp Fibrillation on Heart Recovery
Author Information
Author(s): Dunning Joel, Hunter Steven, Kendall Simon WH, Wallis John, Owens W Andrew
Primary Institution: Department of Cardiothoracic Surgery, James Cook University Hospital, Middlesbrough, UK
Hypothesis
Can we define a 'safe-ischaemic time' for cross-clamping during coronary bypass grafting?
Conclusion
Crossclamp fibrillation does not result in reliable reperfusion of the myocardium between periods of crossclamping.
Supporting Evidence
- The pH of the myocardium dropped significantly during cross-clamp periods.
- Some patients showed complete failure to recover pH after cross-clamp release.
- The study suggests that ischaemic preconditioning may occur in patients who recover.
Takeaway
Doctors wanted to see if a method called cross-clamp fibrillation helps the heart recover during surgery, but they found it doesn't work well.
Methodology
16 patients undergoing CABG with cross-clamp fibrillation had their pH monitored in real-time using a Khuri intramyocardial pH probe.
Potential Biases
The division of patients into recoverers and non-recoverers was retrospective and may not represent distinct groups.
Limitations
The study's preliminary nature and the retrospective grouping of patients may not accurately reflect the true spectrum of recovery.
Participant Demographics
{"age":"67 (SD 9)","male":15,"diabetes":1,"smokers":12,"BMI":"28 (SD 3)","EF":"63 (SD 14)","prev_MI":7,"LMS_disease":9,"triple_vessel_disease":14}
Statistical Information
P-Value
<0.0005
Statistical Significance
p<0.0005
Digital Object Identifier (DOI)
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