{"title":"Angioplasty balloon occlusion of LIMA graft in reoperations of patients with prosthetic valve endocarditis and patent LIMA-LAD graft.","authors":"Ivilin Plamenov Todorov, Zdravka Petrova Todorova, Dimitar Petrov Nikolov","doi":"10.5114/kitp.2022.122089","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Myocardial protection in reoperative cardiac surgery is extremely difficult in patients with previous coronary surgery and a working LAD-LIMA graft. We use the method of percutaneous angiographic balloon left internal mammary artery (LIMA) occlusion and cardioplegic arrest.</p><p><strong>Aim: </strong>To compare the data of patients with angiographic balloon LIMA-occlusion and those without occlusion in operations related to prosthetic valve endocarditis (PVE), and determine the degree of safety and benefits of the method.</p><p><strong>Material and methods: </strong>A total of 20 patients undergoing surgery for PVE with a patent LIMA-LAD graft were analyzed retrospectively. We divided the patients into 2 groups: group A - patients with LIMA occlusion; and group B - patients without LIMA occlusion. The pre-, intra- and postoperative results were compared and the degree of safety and benefits of the application of the method were studied.</p><p><strong>Results: </strong>80% of patients in group A needed only dopamine infusion and 20% needed the addition of a second catecholamine at the end of CPB. In group B, the need for double catecholamine maintenance was noted in 50% of patients. The need for implantation of an intra-aortic balloon pump due to refractory heart failure was registered in 10% of patients in group A and in 20% of patients in group B. In terms of survival, mortality in the group with LIMA occlusion was 0%, while in the group without LIMA occlusion it was 20%.</p><p><strong>Conclusions: </strong>Our observations suggest that angiographic balloon LIMA occlusion is a reliable, easily applicable and relatively safe technique that improves the surgical results.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"19 4","pages":"199-204"},"PeriodicalIF":0.6000,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b2/fb/KITP-19-48511.PMC9809192.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Kardiochirurgia I Torakochirurgia Polska","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5114/kitp.2022.122089","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Myocardial protection in reoperative cardiac surgery is extremely difficult in patients with previous coronary surgery and a working LAD-LIMA graft. We use the method of percutaneous angiographic balloon left internal mammary artery (LIMA) occlusion and cardioplegic arrest.
Aim: To compare the data of patients with angiographic balloon LIMA-occlusion and those without occlusion in operations related to prosthetic valve endocarditis (PVE), and determine the degree of safety and benefits of the method.
Material and methods: A total of 20 patients undergoing surgery for PVE with a patent LIMA-LAD graft were analyzed retrospectively. We divided the patients into 2 groups: group A - patients with LIMA occlusion; and group B - patients without LIMA occlusion. The pre-, intra- and postoperative results were compared and the degree of safety and benefits of the application of the method were studied.
Results: 80% of patients in group A needed only dopamine infusion and 20% needed the addition of a second catecholamine at the end of CPB. In group B, the need for double catecholamine maintenance was noted in 50% of patients. The need for implantation of an intra-aortic balloon pump due to refractory heart failure was registered in 10% of patients in group A and in 20% of patients in group B. In terms of survival, mortality in the group with LIMA occlusion was 0%, while in the group without LIMA occlusion it was 20%.
Conclusions: Our observations suggest that angiographic balloon LIMA occlusion is a reliable, easily applicable and relatively safe technique that improves the surgical results.
期刊介绍:
Polish Journal of Thoracic and Cardiovascular Surgery is a quarterly aimed at cardiologists, cardiosurgeons and thoracic surgeons. Includes the original works (experimental, research and development), illustrative and casuistical works about cardiology and cardiosurgery.