Biochemical Indicators of Myocardial Ischaemia During Coronary Artery Bypass Grafting

Seppo Kaukinen Departments of Anaesthesia and Surgery, Tampere University Central Hospital, Tampere, Finland; Department of Biomedical Sciences, Tampere University, Tampere, Finland

Timo Metsä-ketelä Departments of Anaesthesia and Surgery, Tampere University Central Hospital, Tampere, Finland; Department of Biomedical Sciences, Tampere University, Tampere, Finland

Liisa Kaukinen Departments of Anaesthesia and Surgery, Tampere University Central Hospital, Tampere, Finland; Department of Biomedical Sciences, Tampere University, Tampere, Finland

Raimo Ojanen Departments of Anaesthesia and Surgery, Tampere University Central Hospital, Tampere, Finland; Department of Biomedical Sciences, Tampere University, Tampere, Finland

Heikki Wuorela Departments of Anaesthesia and Surgery, Tampere University Central Hospital, Tampere, Finland; Department of Biomedical Sciences, Tampere University, Tampere, Finland

Keikki Riekkinen Departments of Anaesthesia and Surgery, Tampere University Central Hospital, Tampere, Finland; Department of Biomedical Sciences, Tampere University, Tampere, Finland

Abstract

Metabolic indicators of myocardial ischaemia were measured in coronary sinus blood in six patients undergoing coronary artery bypass grafting (CABG). Five arterial and coronary sinus blood samples were taken in each case—one before cardiopulmonary bypass (CPB), and three during and one after CPB. Moderate hypothermia with topical cardiac cooling and cold cardioplegia were used. Myocardial infarction occurred perioperatively in two patients. Myocardial lactate production was not found before CPB in any patient, but it was common during CPB. Adenosine, inosine and hypoxanthine were released into the coronary sinus blood, but their release did not correlate significantly with lactate production. Myocardial nor-adrenaline production showed positive correlation with lactate levels (p<0.05). Release of adrenaline from the myocardium during CABG was also demonstrated. Myocardial catecholamine production was especially seen in the patients with myocardial infarction. Myocardial catecholamine release seemed to be the most sensitive of the studied biochemical indicators of myocardial ischaemia during CABG.

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Biochemical Indicators of Myocardial Ischaemia During Coronary Artery Bypass Grafting

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Biochemical Indicators of Myocardial Ischaemia During Coronary Artery Bypass Grafting

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