Cardiopulmonary Bypass and Internal Thoracic Arteries: Can Roller or Centrifugal Pumps Change Vascular Reactivity of the Grafts
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Coronary Disease
- Sponsor
- University Hospital, Angers
- Enrollment
- 80
- Primary Endpoint
- Myography
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
Cardiopulmonary bypass (CPB) induces a systemic inflammatory response and affects the organ vascular bed. Experimentally, the lack of pulsatility alters myogenic tone of resistance arteries and increases the parietal inflammatory response. The purpose of this study was to compare the vascular reactivity and the inflammatory response of the internal thoracic arteries (ITAs) between patients undergoing coronary artery bypass grafting (CABG) under CPB with a roller pump or with a centrifugal pump.
Detailed Description
Eighty elective male patients undergoing CABG were selected using one or two internal thoracic arteries under CPB with a roller pump (RP group) or centrifugal pump (CFP group). ITA samples were collected before starting CPB (Time 1) and before the last coronary anastomosis during aortic cross clamping (Time 2). Terminal complement complex activation (SC5b-9) and neutrophil activation (elastase) analysis were performed on arterial blood at the same times.
Investigators
Eligibility Criteria
Inclusion Criteria
- •male patients and elective coronary artery bypass grafting using at least one of the two ITAs.
Exclusion Criteria
- •female patients because their complement activation has been shown to be greater than that in men during surgery under cardiopulmonary bypass ; age \< 18 years; CABG requiring additional valve repair or replacement; emergency surgery and insufficient length of the internal thoracic artery
Outcomes
Primary Outcomes
Myography
Time Frame: 1 day
for each patient, 2 fresh segments of ITA (Time 1 and Time 2) stored in PSS were analyzed. On day+1, these segments were mounted on a wire-myograph (DMT, Aarhens, DK) . Two tungsten wires (25 μm diameter) were inserted into the lumen of the arteries and connected to a force transducer and a micrometer, respectively. The arteries were bathed in the PSS solution. Wall tension, equivalent to intra-arterial pressure (90 mmHg), was applied and the blood vessels were allowed to stabilize for thirty minutes. Arterial contractility was assessed with phenylephrine (PE, 10 μmol/L). Acetylcholine-induced (Ach 10 μmol/L) relaxation was then obtained after phenylephrine-induced preconstruction (50% of maximal contraction) in the presence or in the absence of the NO synthesis blocker L-NMMA (3.10-4 mol/L) and in the presence or in the absence of the COX synthesis blocker Indomethacin (10-5 mol/L).
Secondary Outcomes
- Quantitative real time transcription-polymerase chain reaction (RT-PCR) analysis(1 day)
- Immunochemistry(1 day)
- Superoxide detection and confocal microscopy(1 day)
- Blood sampling and biochemical analysis(2 hours)