Effect of Advanced Age on Off-pump Coronary Artery Bypass Grafting.

OBJECTIVE: To investigate the perioperative features of aged patients undergoing off-pump coronary artery bypass grafting (OPCABG) surgery, and identify the perioperative effect of advanced age on OPCABG. METHOD: A total of 61 aged patients and 585 younger patients from August 2013 to June 2014 were enrolled in this study. The perioperative features were summarized, and the effects of advanced age on intraoperative variables, as well as the postoperative complications were identified using logistic regression analysis. RESULTS: The anastomosis time of the target coronary artery and intraoperative dosage of vasoconstrictor drugs was significantly longer or higher in the aged patients. The incidence of the postoperative complications, such as atrial fibrillation, repetitive mechanical ventilation, gastrointestinal dysfunction, and renal insufficiency, were significantly higher in the aged patients. The intubation time and postoperative hospital stay were significantly longer in the aged patients. No significant difference was found between the two groups in cardiocerebrovascular accident and mortality. Multivariate logistic regression analysis revealed advanced age was the independent risk factor for coronary artery anastomosis time, vasoconstrictor dosage, repeated mechanical ventilation, atrial fibrillation, gastrointestinal dysfunction, as well as the intubation time and hospital stay. CONCLUSION: OPCABG in aged patients was safe and effective for avoiding a significant increase for cardiocerebrovascular accident and mortality. Relatively, the tolerance of aged heart to stimulation was poor. Atrial fibrillation, repetitive mechanical ventilation, and gastrointestinal dysfunction were more likely to occur in aged patients. Advanced age made intubation time and hospital stay prolonged significantly.

Effective pulmonary artery perfusion mode during cardiopulmonary bypass.

AIM: Reducing lung injury during cardiopulmonary bypass (CPB) is important for patients' recovery. The present study was designed to research convenient and effective pulmonary artery perfusion mode during CPB in an animal model. METHODS: Twelve healthy mongrel dogs were randomly divided into 2 groups: a control group and a perfusion group designed to simulate clinical CPB-induced lung injury. During CPB, pulmonary artery perfusion with modified low-potassium dextran (LPD) solution was performed immediately after the initiation of ischemia and before reperfusion for 3 to 4 minutes each time, with pressure maintained at 15 to 20 mmHg; animals in the control group were not perfused. After pulmonary reperfusion, the changes in pulmonary function and tissue biochemical data were determined. RESULTS: Compared with the control group, lung compliance, oxygenation, and vascular resistance after reperfusion were significantly improved in the perfusion group. The malonaldehyde concentration, neutrophil sequestration ratio, and tissue water content also decreased significantly in the perfusion group. CONCLUSION: The pulmonary artery perfusion mode used in this experiment could relieve CPB-induced lung injury effectively. Improving cellular tolerance to hypoxia and decreasing inflammatory reaction may be the important mechanisms. Moreover, this mode is convenient and does not interfere with the intended operations, which is promising for clinical use.

Co-cultured the MSCs and cardiomyocytes can promote the growth of cardiomyocytes.

Recently, the incidence of myocardial infarction has been increasing annually. Now cell therapy is a major new strategy in the treatment of this public health challenge. Most recently, evidences showed that MSCs can reduce the area of infarction and improve the heart function. In our study we found that MSCs could promote cardiomyocytes proliferation, inhibit the apoptosis of cardiomyocytes and promote cardiomyocytes autophagy function. These functions could be a therapeutic effect on myocardial infarction. At the same time, we first revealed that MSCs may achieve these functions by the activation of VEGF signaling pathways.