Effect of Different Operative Techniques for Myocardial Revascularisation on Hemodynamics and Myocardial Perfusion in a Porcine Model

Bierbach, Benjamin; Kasper-König, W.; Haist, Thomas; Meier, Maxene; Pritzer, H.; Hanenkamp, U; Horstick, Georg; Kempski, Oliver; Oelert, H

doi:10.1055/s-2004-830442

Cited by 5 publications

(7 citation statements)

References 18 publications

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“…The control vessels of the RCx and carotid and renal arteries did not show any significant differences. Untreated IMAs contained very scant adventitial tissue with only few microvessels, as known from previous experiments [17]. The difference between control and post-PTA vessels was significant only for the carotid artery (p < 0.05).…”

Section: Resultssupporting

confidence: 49%

Resistance of the Internal Mammary Artery to Restenosis: A Histomorphologic Study of Various Porcine Arteries

Horstick

Bierbach²,

Schlindwein³

et al. 2007

J Vasc Res

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Background/Aims: Restenosis after percutaneous transluminal angioplasty (PTA) of the internal mammary artery (IMA) grafts is much less pronounced than in other arteries and venous grafts. The aim of the study was to test whether various arteries respond differently to dilatation. Methods: PTA of the IMA, carotid, renal and circumflex coronary (RCx) arteries was performed in 9 pigs (balloon to artery ratio of 1:1.5). After 8 weeks, angiography was repeated and vessels prepared for histological analysis. Immunohistochemical staining was done to examine proliferative activity (Ki67) and to identify the vasa vasorum of the adventitia (F VIII-RA). Results: The intima-media ratio after PTA was lowest in the IMA (0.06), followed by the carotid (0.27) and renal arteries (0.49) and the RCx (0.69). Proliferation of the intima was seen at 287° of the vessel circumference in the RCx, at 286° in the renal and at 166° in the carotid artery. No proliferative activity was seen in the IMA. The intima-adventitia ratio was lower in the IMA than in the RCx and renal arteries (p < 0.05). Conclusion: Intima proliferation after PTA varies between the different vessels, with best results seen in the IMA. There are differences in remodeling after PTA between muscular, muscular/elastic and elastic arteries.

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Section: Resultssupporting

confidence: 49%

Resistance of the Internal Mammary Artery to Restenosis: A Histomorphologic Study of Various Porcine Arteries

Horstick

Bierbach²,

Schlindwein³

et al. 2007

J Vasc Res

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“…11,17 Two million microspheres per color were injected into the left atrium over 30 seconds. During CPB, the microspheres were injected into the arterial canula.…”

Section: Cerebral Perfusion Measurementmentioning

confidence: 99%

“…The pump speed was adjusted to maintain a mean arterial pressure (MAP) between 55 and 80 mm Hg and to avoid the use of vasopressor medication during CPB. 11 In group II, the internal mammary artery-to-left anterior descending coronary artery bypass was performed on the beating-heart with the use of a stabilizer (Octopus Medtronic), with a clamp occluding the completed bypass until the 40th minute. 11 In group III, the blood pump was inserted into the left ventricle via the ascending aorta through a pursestring suture.…”

Section: Surgical Set-upmentioning

confidence: 99%

“…11 In group II, the internal mammary artery-to-left anterior descending coronary artery bypass was performed on the beating-heart with the use of a stabilizer (Octopus Medtronic), with a clamp occluding the completed bypass until the 40th minute. 11 In group III, the blood pump was inserted into the left ventricle via the ascending aorta through a pursestring suture. Hydroxethylstarch (6%, 500 mL; Braun, Melsungen, Germany) was infused immediately before pump insertion.…”

Section: Surgical Set-upmentioning

confidence: 99%

“…9,10 Hemodynamic stabilization during beating-heart myocardial revascularization by an intracardiac implanted blood pump can be achieved in experimental and clinical settings. [11][12][13][14] The Impella Elect 100 blood pump (Impella Cardiosystems, Aachen, Germany) has been developed to avoid hemodynamic instabilities while retracting the heart for exposure.…”

mentioning

confidence: 99%

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Emboli Formation Rather Than Inflammatory Mediators Are Responsible for Increased Cerebral Water Content After Conventional and Assisted Beating-Heart Myocardial Revascularization in a Porcine Model

Bierbach¹,

Meier²,

Kasper-König³

et al. 2008

Stroke

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Background and Purpose-Emboli and proinflammatory mediators are suspected of generating cerebral edema after coronary surgery. In contrast to cardiopulmonary bypass (CPB), off-pump coronary artery bypass surgery (OPCAB) reduces microemboli count and proinflammatory mediator release but carries the risk of hemodynamic instability. A microaxial blood pump can augment cardiac output. Methods-Coronary bypasses were constructed in pigs with CPB and cardioplegia (nϭ9), OPCAB (nϭ9), or blood-pump support CAB (nϭ9). Nine animals underwent sham operation. Embolus count was monitored and regional cerebral blood flow was assessed with microspheres in 21 brain specimens per animal (nϭ189 per group). Interleukins 6 and 8 and tumor necrosis factor-␣ concentrations were determined. These variables were studied before, during, and for 4 hours after surgery. Finally, cerebral water content was determined. Results-During CPB and blood-pump CAB, a significant number of emboli were counted in contrast to OPCAB and controls (PϽ0.05). During CPB, regional cerebral blood flow was affected (32 of 189) and showed reactive hyperemia except in 10 specimens after aortic cross-clamp release. This impairment persisted in 20 specimens. During and after OPCAB, regional cerebral blood flow remained nearly unchanged but showed low flow during (58 of 189) and after (35 of 189) the blood-pump run. A significant increase in proinflammatory mediators was observed only in the CPB group. CPB and blood-pump CAB significantly increased cerebral water content (PϽ0.05). A strong correlation between embolic load and cerebral water content was observed in all groups. No correlation between proinflammatory mediator release and cerebral water content was detected. Conclusions-Emboli formation rather than inflammatory mediators are responsible for increased cerebral water content after conventional and assisted beating-heart myocardial revascularization. (Stroke. 2008;39:213-219.)

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Porcine model for free-flap breast reconstruction training

Bodin¹,

Diana²,

Koutsomanis³

et al. 2015

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Effect of Different Operative Techniques for Myocardial Revascularisation on Hemodynamics and Myocardial Perfusion in a Porcine Model

Abstract: ECC led to hemodynamic impairment with post-ischemic reactive hyperemia. OPCAB created hemodynamic depression but left RMP unchanged. Hemodynamic depression can be reduced by the Impella pump, however regional myocardial blood flow is decreased.

Cited by 5 publications

References 18 publications

Resistance of the Internal Mammary Artery to Restenosis: A Histomorphologic Study of Various Porcine Arteries

Resistance of the Internal Mammary Artery to Restenosis: A Histomorphologic Study of Various Porcine Arteries

Emboli Formation Rather Than Inflammatory Mediators Are Responsible for Increased Cerebral Water Content After Conventional and Assisted Beating-Heart Myocardial Revascularization in a Porcine Model

Porcine model for free-flap breast reconstruction training

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