Coronary endothelial injury after local occlusion on the human beating heart.
Ann Thorac Surg
; 71(1): 122-7, 2001 Jan.
Article
em En
| MEDLINE
| ID: mdl-11216730
ABSTRACT
BACKGROUND:
Occlusion of coronary arteries during beating heart surgery bears the potential for mechanical trauma to the arterial wall with consequent endothelial injury. The aim of this study was to elucidate the effects of local occlusion on the beating heart in human coronary arteries.METHODS:
Coronary arteries of patients with dilated cardiomyopathy (n = 7) or ischemic heart disease (n = 10) undergoing heart transplantation were locally occluded after starting cardiopulmonary bypass. Immediately after excision of the diseased heart, the vessels were fixed. Unoccluded segments served as controls. Integrity of endothelial lining was observed with scanning electron microscopy.RESULTS:
Scanning electron microscopy revealed significantly more severe endothelial injury in the area of occlusion than in the adjacent, not manipulated control segments. In the region of local occlusion, plaque rupture was noted in three of 34 atherosclerotic vessel specimens, injury to side branches was evident in two of 44, and local microthrombus formation was evident in six of 44 samples.CONCLUSIONS:
Local occlusion of human coronary arteries during beating heart coronary surgery may cause focal endothelial denudation, local microthrombosis, atherosclerotic plaque rupture, and injury to target vessel side branches.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Endotélio Vascular
/
Ponte Cardiopulmonar
/
Transplante de Coração
/
Vasos Coronários
Limite:
Humans
Idioma:
En
Revista:
Ann Thorac Surg
Ano de publicação:
2001
Tipo de documento:
Article
País de afiliação:
Áustria