RESUMO
AIM: To investigate and compare uncoated and phosphorylcholine-coated oxygenators in terms of induction of humoral immune response during coronary artery bypass surgery. METHODS: A total of 20 consecutive patients who underwent coronary artery bypass surgery were randomly distributed into two groups according to the type of oxygenator used during surgery. Group 1 consisted of 10 patients who were operated on using phosphorylcholine-coated oxygenators. Group 2 contained 10 patients who underwent surgery using uncoated oxygenators. Blood and oxygenator fibre samples were obtained and compared in terms of immunoglobulins (IgG, IgM), complements (C3c, C4), serum total protein and albumin levels using electron microscopy and flow cytometry. RESULTS: In group 1, levels of IgM, IgG, total protein and serum albumin were significantly increased at the end of cardiopulmonary bypass (CPB) compared to those at the beginning of CPB. In group 2, C3c and C4 levels at the beginning of CPB were found to be significantly higher than at the end. Electron microscopic examination of oxygenator fibres demonstrated that phosphorylcholine-coated fibres were less likely to be adsorbed by serum proteins and complements than the uncoated fibres. CONCLUSION: Our results indicate that phosphorylcholine-coated oxygenators seemed to induce humoral immune response to a lesser extent than uncoated oxygenators during coronary artery bypass procedures.
Assuntos
Ponte Cardiopulmonar/instrumentação , Materiais Revestidos Biocompatíveis , Ponte de Artéria Coronária , Imunidade Humoral , Oxigenadores de Membrana , Fosforilcolina/imunologia , Adsorção , Idoso , Biomarcadores/sangue , Ponte Cardiopulmonar/efeitos adversos , Materiais Revestidos Biocompatíveis/efeitos adversos , Complemento C3c/metabolismo , Complemento C4/metabolismo , Ponte de Artéria Coronária/efeitos adversos , Estudos Transversais , Desenho de Equipamento , Feminino , Citometria de Fluxo , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Microscopia Eletrônica , Pessoa de Meia-Idade , Oxigenadores de Membrana/efeitos adversos , Fosforilcolina/efeitos adversos , Fosforilcolina/metabolismo , Albumina Sérica/metabolismo , Albumina Sérica Humana , Propriedades de Superfície , Resultado do Tratamento , TurquiaAssuntos
Aorta Torácica , Doenças da Aorta/complicações , Equinococose/complicações , Embolia/etiologia , Adulto , Albendazol/uso terapêutico , Anti-Helmínticos/uso terapêutico , Aorta Torácica/diagnóstico por imagem , Aorta Torácica/parasitologia , Aorta Torácica/cirurgia , Doenças da Aorta/diagnóstico , Doenças da Aorta/parasitologia , Doenças da Aorta/terapia , Aortografia/métodos , Biópsia , Implante de Prótese Vascular , Equinococose/diagnóstico , Equinococose/parasitologia , Equinococose/terapia , Embolia/diagnóstico , Embolia/terapia , Feminino , Humanos , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
This study compared the effects of different methods of papaverine application on free blood flow and harvesting time of the internal thoracic artery for coronary bypass grafting. Patients were randomly divided into 3 groups of 25 each: group 1 had papaverine injected into the endothoracic tissue around the internal thoracic artery before dissection, group 2 had papaverine injected into the periarterial tissues of the internal thoracic artery pedicle, and group 3 had intraluminal papaverine applied retrogradely into the internal thoracic artery. Mean blood flow was 56.3 +/- 21.3, 21.1 +/- 13.2, and 20.9 +/- 9.1 mL x min(-1) in groups 1, 2, and 3, respectively, immediately after harvesting. Flow in group 1 was significantly better than that in groups 2 and 3. Immediately before anastomosis, mean flow was 89.8 +/- 19.1, 97.6 +/- 35.4, and 95.9 +/- 19.9 mL x min(-1) in groups 1, 2, and 3, respectively, with no significant difference among groups. Internal thoracic artery harvesting times were shorter in group 1 than in groups 2 and 3. Administering papaverine into the endothoracic fascia of the internal thoracic artery bed prior to dissection is a reliable method that facilitates rapid harvesting of the graft without causing trauma and consequent spasm.