Feasibility of Intravascular Near-Infrared Spectroscopy in Off-Pump Myocardial Revascularization

2006 ◽  
Vol 1 (5) ◽  
pp. 258-262
Author(s):  
Franziska H. Bernet ◽  
Peter Matt ◽  
Hans-Reinhard Zerkowski ◽  
Doan Baykut
Keyword(s):  
Infrared Spectroscopy ◽  
Myocardial Ischemia ◽  
Near Infrared Spectroscopy ◽  
Coronary Sinus ◽  
Bypass Surgery ◽  
Near Infrared ◽  
Coronary Bypass ◽  
Coronary Bypass Surgery ◽  
Off Pump ◽  
Coronary Sinus Blood

Objectives The intravascular application of near-infrared spectroscopy was previously evaluated in acute ischemia-reperfusion studies in animal experiments. The objective of our study was to assess the technical feasibility and clinical reliability of an online myocardial ischemia monitoring by using intravascular near-infrared spectroscopy during off-pump coronary bypass surgery. Methods Intravascular near-infrared spectroscopy of coronary sinus blood was performed in 10 elective patients selected for off-pump coronary bypass surgery. Light signals were transferred through a fiberoptic catheter for emission and collection from the coronary sinus blood. Spectrometric analyses were performed before and after revascularization with internal thoracic artery and saphenous vein grafts. Changes in spectroscopic data were compared with hemodynamic parameters and electrocardiographic, transesophageal echocardiographic, and laboratory findings. Results All of the operations were finished as off-pump procedures. No remarkable intraoperative myocardial ischemia was observed in the patient group, as indicated by electrocardiography and transesophageal echocardiography. Reproducible absorption spectra of coronary sinus blood were obtained at every defined step of the surgical procedure. Clear ischemia-related changes were detected in none of the patients. Conclusions Our initial results showed that intravascular near-infrared spectroscopic ischemia monitoring is technically feasible. However, the method must be further evaluated and standardized under varying conditions to determine the role of near-infrared spectroscopy as an ischemia monitoring tool in off-pump coronary bypass surgery.

Gender differences in secretion of adipokines off pump coronary bypass surgery (OPCAB)

2013 ◽  
Vol 61 (S 01) ◽  
Author(s):  
H Loeblein ◽  
O Dzemali ◽  
K Graves ◽  
A Kostorz ◽  
C Meier ◽  
...  
Keyword(s):  
Gender Differences ◽  
Bypass Surgery ◽  
Coronary Bypass ◽  
Coronary Bypass Surgery ◽  
Off Pump

Selective Use of Off-Pump Coronary Bypass Surgery Reduces Mortality and Neurologic Morbidity Associated with High-Risk Coronary Bypass Surgery: A 400-Case Comparative Experience

2004 ◽  
Vol 7 (6) ◽  
pp. E562-E568
Author(s):  
Jeffrey P. Gold ◽  
John Wasnick ◽  
William Maldarelli ◽  
Ilya Zhuraavlev ◽  
Kaila Enitt Torres ◽  
...  
Keyword(s):  
High Risk ◽  
Bypass Surgery ◽  
Coronary Bypass ◽  
Coronary Bypass Surgery ◽  
Off Pump

Evaluation of extracranial—intracranial arterial bypass function by using near-infrared spectroscopy

2003 ◽  
Vol 99 (2) ◽  
pp. 304-310 ◽  
Author(s):  
Yoshihiro Murata ◽  
Yoichi Katayama ◽  
Kaoru Sakatani ◽  
Chikashi Fukaya ◽  
Tsuneo Kano
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Sensorimotor Cortex ◽  
Bypass Surgery ◽  
Near Infrared ◽  
Cutoff Value ◽  
Content Type ◽  
Arterial Bypass ◽  
Group Iii ◽  
Fine Print

Object. It has been reported that extracranial—intracranial (EC—IC) arterial bypass surgery can be useful in preventing stroke in patients with hemodynamic compromise. Little is yet known, however, regarding the extent to which the bypass contributes to maintaining adequate cerebral blood oxygenation (CBO) and its temporal changes following surgery. The authors evaluated bypass function repeatedly by using near-infrared spectroscopy (NIRS) after surgery. Methods. The authors investigated 30 patients who had undergone EC—IC bypass surgery. Single-photon emission computerized tomography revealed a decrease in regional cerebral blood flow (rCBF) and a lowered rCBF response to acetazolamide. Changes in CBO were evaluated in the sensorimotor cortex during compression of the anastomosed superficial temporal artery (STA). When decreases in oxyhemoglobin (HbO2) and total hemoglobin (Hb) concentrations were observed, the bypass was considered to have maintained CBO in the sensorimotor cortex given that decreases in HbO2 and total Hb indicate cerebral ischemic changes. The bypass maintained CBO immediately after surgery in 36.7% of patients (Group I, 11 patients) and at some time after surgery, mostly within 1 year, in 43.3% of patients (Group II, 13 patients); however, it did not maintain it throughout the follow-up period in 20% of patients (Group III, six patients). Note that the preoperative rCBF in patients in Groups I and II was lower than that in patients in Group III (p < 0.004). In fact, the preoperative rCBF predicted whether a bypass would maintain CBO at a cutoff value of 24.5 to 25 ml/100 g/min. Among Groups I and II, 18 patients demonstrated an increase in deoxyhemoglobin during STA compression. The preoperative rCBF in these cases was lower than that in the six remaining patients (p < 0.006). Note that the preoperative rCBF predicted the postoperative deoxyhemoglobin response at a cutoff value of 22.2 to 24 ml/100 g/min. Conclusions. The EC—IC bypass surgery can maintain CBO immediately after surgery or gradually within 1 year when the preoperative rCBF is below 24.5 to 25 ml/100 g/min. Furthermore, bypass flow plays a critical role in maintaining an adequate CBO when preoperative rCBF is below 22.2 to 24 ml/100 g/min.

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