Purpose: The aim of this study was to evaluate the efficacy of octreotide in modulating the progression of intimal hyperplasia in autogenous vein bypass grafts in a canine model. The effect of the drug on the progression of intimal hyperplasia was measured with the Gilman parameter, a measure used extensively as a wound-healing descriptor. Methods: 12 mongrel dogs were randomly and equally divided into two groups. The first group (octreotide group) was administered octreotide 20 µg/kg/day. The control group (group II) received saline solution by subcutaneous injection. Each dog had 8- to 10-cm segments of autogenous jugular vein bypassed to the femoral arteries. Quantitative data on luminel narrowing over time from intimal hyperplasia were compared from calculated Gilman parameters after image analysis of retrieved, histologically processed graft sections. Each vein graft was analyzed by computerized morphometric analysis. Results: The mean Gilman parameter for distal graft segments was 0.47 ± 0.17 mm in the control group and 0.25 ± 0.07 mm in the octreotide group 6 weeks after operation (p < 0.05). Distal graft segments between the control and octreotide groups were statistically significant. In proximal, medial and distal graft segments, the mean Gilman parameters were 0.51 ± 0.16 mm in the control group and 0.37 ± 0.18 mm in the octreotide group, the difference being statistically significant (p < 0.01). Conclusion: Octreotide significantly inhibits myointimal thickening, and these data support the efficacy of octreotide in reducing intimal hyperplasia in arterialized vein grafts during the short postoperative period. Further investigations are required to as certain whether this beneficial effect of octretide persists in the long term.
From January 1984 to December 1993 a total of 154 patients (89 men and 85 women) required 160 reoperations for prosthetic heart valve dysfunction. Four patients required a second, two patients a third reoperation. Age was (mean±SD [rangel) 38.8 ± 10.2 (17 to 64) years. The primary operation was mitral valve replacement in 105 patients, aortic valve replacement in 20, and both aortic and mitral valve replacement in 29. The time interval between initial valve replacement and reoperation was 66.4 ± 40 (3 to 288) months for the mechanical prostheses and 68.7±32 (24 to 140) months for bioprostheses; the differente was not statistically significant. Primary tissue failure was the most common cause of the reoperation for bioprostheses and valve thrombosis for mechanical prostheses. The hospital mortality rate was significantly higher in the replacement of mechanical protheses (14/58 = 24.1 % vs. 7/102 = 6.8 %, p = 0.004). Low preoperative functional capacity and valve thrombosis were linked to higher mortality rates. It is discussed that monoleaflet mechanical valves yielded the highest operative mortality and that, excluding these, the risk of mortality in prosthetic valve reoperations today does not differ much from that in primary valve replacements.
Aortic root surgery has traditionally been performed with an arrested and cooled heart using cardioplegia. A new technique of myocardial protection was utilized in the treatment of ascending aortic aneurysm with severe aortic valve regurgitation requiring aortic root replacement with the Cabrol technique. Retrograde and antegrade perfusion of the heart with blood allowed the surgical operation to be performed safely while the heart was beating and eliminated the ischemic reperfusion injury which occurs during cardioplegic arrest and reinstitution of blood perfusion after removal of the aortic cross-clamping required in traditional techniques.
Gene polymorphisms with regard to prothrombotic factor V Leiden mutation and inflammatory marker interleukin-6 may play a role in the pathogenesis of early-onset coronary artery stenosis in patients below 35 years of age.
Magnesium, if administered in an antegrade direction had only a limited effect, whereas magnesium-enriched retrograde coronary sinus perfusions appeared to significantly protect the ischaemic myocardium against the hazardous effects of ischaemic reperfusion injury.
The use of ITA grafts was effective in improving both the postoperative survival and cardiac event-free rates, and should be recommended in patients with diabetes mellitus or left ventricular dysfunction. ITA grafting to the LAD should be a routine operation in almost all categories of such patients.
This study was planned to show th e effect of retroperfusion and intraaortic ba lloon pumping (lABP) on myocardial hem odynamic recovery. Twelve dogs ente re d thi s study. Half ofthem received IABP and coro na ry sin us retr operfusion (CSPR) combination (Group II) a nd the remaining received IABP alone (Group I). Left a nte rior descending artery was occluded for a peri od of three hours. 15 min utes aft er occlusio n IABP and IABP + CSRP wer e initia ted. The aver age ca rdiac output was 1.41 ±0.18 Ll min in th e gro up I and 1.72± 0 .24 Umin in the gr oup II (p < 0.03) after 3 hours of occlusio n. Mean a rte rial pr essure was 82.1 ± 4.8 mmHg in th e group I and 89 .7 ± 2.6 mmHg in th e gro up II (p < 0.03). On th e basis of this stu dy it was conclud ed that CSRP + IABP could be an alt ernative treatment to IABP alone during the acutely developing ischemia.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.