Avaliação imediata da troponina I cardíaca em pacientes submetidos à revascularização do miocárdio

Leal, João Carlos Ferreira; Braile, Domingo Marcolino; Godoy, Moacir F.; Neto, José Purini; Neto, Alfredo de Paula; Ramin, Serginando L; Zaiantchick, Marcos

doi:10.1590/s0102-76381999000300009

Cited by 7 publications

(7 citation statements)

References 7 publications

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“…The occurrence of perioperative MI was assessed considering ST segment elevation greater than 1 mm in the limb leads or 2 mm in precordial leads in at least two contiguous leads, or some area of necrosis that did not exist in the preoperative ECG. We also analyzed elevation of creatine kinase (CK-MB) above 100 IU/l in the first two days of postoperative troponin I level or above 2.5 ng/ mL within 48 hours after surgery, as quoted by Leal [ 10 ] .…”

Section: Methodsmentioning

confidence: 99%

Comparative analysis of the patency of the internal thoracic artery in the CABG of left anterior descending artery: 6-month postoperative coronary CT angiography evaluation

Deininger¹,

Moreira²,

Dallan³

et al. 2014

Revista Brasileira De Cirurgia Cardiovascular

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Objective To assess the patency of the pedicled right internal thoracic artery with an anteroaortic course and compare it to the patency of the left internal thoracic artery , in anastomosis to the left anterior descending artery in coronary artery bypass grafting by using coronary CT angiography at 6 months postoperatively. Methods Between December 2008 and December 2011, 100 patients were selected to undergo a prospective coronary artery bypass grafting procedure without cardiopulmonary bypass. The patients were randomly divided by a computer-generated list into Group-1 (G-1) and Group-2 (G-2), comprising 50 patients each, the technique used was known at the beginning of the surgery. In G-1, coronary artery bypass grafting was performed using the left internal thoracic artery for the left anterior descending and the free right internal thoracic artery for the circumflex, and in G-2, coronary artery bypass grafting was performed using the right internal thoracic artery pedicled to the left anterior descending and the left internal thoracic artery pedicled to the circumflex territory. Results The groups were similar with regard to the preoperative clinical data. A male predominance of 75.6% and 88% was observed in G-1 and G-2, respectively. Five patients migrated from G-1 to G-2 because of atheromatous disease in the ascending aorta. The average number of distal anastomoses was 3.48 (SD=0.72) in G-1 and 3.20 (SD=0.76) in G-2. Coronary CT angiography in 96 re-evaluated patients showed that all ITAs, right or left, used in situ for the left anterior descending were patent. There were no deaths in either group. Conclusion Coronary artery bypass grafting surgery involving anastomosis of the anteroaortic right internal thoracic artery to the left anterior descending artery has an outcome similar to that obtained using the left internal thoracic artery for the same coronary site.

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Section: Methodsmentioning

confidence: 99%

Comparative analysis of the patency of the internal thoracic artery in the CABG of left anterior descending artery: 6-month postoperative coronary CT angiography evaluation

Deininger¹,

Moreira²,

Dallan³

et al. 2014

Revista Brasileira De Cirurgia Cardiovascular

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“…As already reported in the literature, levels of troponin, either I or T, raise at the first postoperative day of coronary artery bypass grafting, even without ischemic event associated [8]. The identification of a cut-off value for troponin I is important because it becomes another tool for diagnosis of postoperative myocardial infarction, which has a major negative impact for recovering of postoperative patients [6].…”

Section: Discussionmentioning

confidence: 89%

“…Its value in diagnosis of myocardial infarction is well known in clinical patients, but it is still under study in patients already grafted, [1,[3][4][5][6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

Importância da troponina I no diagnóstico do infarto do miocárdio no pós-operatório de cirurgia de revascularização

Oliveira¹,

Botelho²,

Brandi³

et al. 2009

Rev Bras Cir Cardiovasc

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Importância da troponina I no diagnóstico do infarto do miocárdio no pós-operatório de cirurgia de revascularizaçãoThe importance of troponin I in the diagnosis of myocardial infarction in the postoperative of coronary artery bypass graft surgery Abstract Objective: The aim of this study is to establish a cut-off value for troponin I by correlating it to occurrence of postoperative myocardial infarction.Methods: 180 consecutive patients with coronary disease referred for surgery were included. The mean age of the patients were 60.6 (±9.3) years, with 119 (66.1%) males and 61 (33.9%) females. The patients were divided into two groups: group without myocardial infarction (A) -170 patients -and with myocardial infarction (B) -10 patients.The troponin I was collected from each patient at the beginning of anesthesia and on the second postoperative day by correlating it to presence or not of postoperative myocardial infarction. StatsDirect 1.6.0 for Windows was used for statistical analysis.Results: Preoperative troponin I was 1.0 (±6) ng/ml as mean. Univariate logistic regression showed correlation of troponin I of the second postoperative day with myocardial infarction (P=0.0005). ROC curve was used to define the cut-off value, and 6.1 ng/ml (sensitivity=90.0%, specificity=82.1%, OR=49.8 with CI=95% 6.1-410.4, P<0.0001) were found.Conclusion: The chance of a patient with postoperative myocardial infarction to present troponin I equal to or higher than 6.1 ng/ml is 49.8-fold higher than the chance of a patient without infarction to present troponin I higher than this value. Resultados: A troponina I pré-operatória apresentou uma

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“…The incidence of perioperative myocardial infarction in CABG ranges from 2 to 15% [ 16 ] , and this variation can be explained by the absence of a gold standard test in the specific situation of infarction after coronary revascularization. In addition, electrocardiographic changes and elevation of cardiac enzymes in the postoperative period, even in patients without myocardial ischemia may occur [ 17 , 18 ] .…”

Section: Discussionmentioning

confidence: 99%

Improvement in cardioplegic perfusion technique in single aortic clamping - Initial Results

Sobral¹,

Júnior²,

Sá³

et al. 2014

Revista Brasileira De Cirurgia Cardiovascular

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Introduction The most common method used for myocardial protection is administering cardioplegic solution in the coronary circulation. Nevertheless, protection may be achieved by intermittent perfusion of the coronary system with patient's own blood. The intermittent perfusion may be performed by multiple sequences of clamping and opening of the aortic clamp or due single clamping and accessory cannulation of the aortic root as in the improved technique proposed in this study, reperfusion without the need for multiple clamping of the aorta. Objective To evaluate the clinical outcome and the occurrence of neurological events in in-hospital patients submitted to myocardial revascularization surgery with the "improved technique" of intermittent perfusion of the aortic root with single clamping. Methods This is a prospective, cross-sectional, observational study that describes a myocardial management technique that consists of intermittent perfusion of the aortic root with single clamping in which 50 patients (mean age 58.5±7.19 years old) have been submitted to the myocardial revasculrization surgery under the proposed technique. Clinical and laboratory variables, pre- and post-surgery, have been assessed. Results The mean peak level of post-surgery CKMB was 51.64±27.10 U/L in the second post-surgery and of troponin I was 3.35±4.39 ng/ml in the fourth post-surgery, within normal limits. No deaths have occurred and one patient presented mild neurological disorder. Hemodynamic monitoring has not indicated any changes. Conclusion The myocardial revascularization surgery by perfusion with the improved technique with intermittent aortic root with single clamping proved to be safe, enabling satisfactory clinical results.

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Avaliação imediata da troponina I cardíaca em pacientes submetidos à revascularização do miocárdio

Cited by 7 publications

References 7 publications

Comparative analysis of the patency of the internal thoracic artery in the CABG of left anterior descending artery: 6-month postoperative coronary CT angiography evaluation

Comparative analysis of the patency of the internal thoracic artery in the CABG of left anterior descending artery: 6-month postoperative coronary CT angiography evaluation

Importância da troponina I no diagnóstico do infarto do miocárdio no pós-operatório de cirurgia de revascularização

Improvement in cardioplegic perfusion technique in single aortic clamping - Initial Results

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