Assessing myocardial perfusion with Albunex during coronary artery bypass surgery: technical considerations and safety of aortic root injections.
OBJECTIVE
To test the safety and report on limiting technical considerations, including optimal dosing of Albunex (Molecular Biosystems, Inc, Mallinckrodt Medical, St. Louis, MO) for myocardial opacification after intra-aortic root injections during cardiac surgery.


METHODS
This was a prospective randomized study with a control group who did not receive Albunex and a group who received intra-aortic root injections of Albunex.


METHODS
Multicenter (two) independent university hospitals.


METHODS
32 patients scheduled for elective coronary artery bypass surgery were evaluated after individual informed consent was obtained.


METHODS
2 to 8 mL of Albunex were injected before and after coronary revascularization.


RESULTS
Quality of enhancement in each of four regions of the left ventricle was assessed from a short-axis mid-papillary ultrasound image by three experienced observers blinded to dose. Electrocardiogram (ECG), creatine phosphokinase (CPK) (MB fraction), and hemodynamics were evaluated at baseline and throughout the study period for up to 72 hours. No differences were noted between groups with respect to preoperative and postoperative CPK enzymes (CPK-MB fraction), ECG changes, hemodynamics, requirements for separation from CPB, need for postoperative inotropes, time to extubation, and time to discharge from the intensive care unit. The average total dose of Albunex injected was 19 mL +/- 4 (0.25 mL/kg). A single dose of 4.2 +/- 1.2 mL (0.05 mL/kg) appeared to offer optimal enhancement of contrast effect for myocardial perfusion assessment.


CONCLUSIONS
Albunex is safe and easy to use for myocardial opacification when administered via an antegrade cardioplegia catheter into the aortic root during CPB.
Aronson
S
S
Department of Anesthesia and Critical Care, University of Chicago, IL 60637, USA.
Savage
R
R
Fernandez
A
A
Klein
A
A
Young
C
C
Toledano
A
A
Lee
B K
BK
Karp
R B
RB
Lytle
B
B
Loop
F
F
D000368:Aged; D000418:Albumins / Q000009:adverse effects*; D003287:Contrast Media / Q000009:adverse effects*; D001026:Coronary Artery Bypass; D003402:Creatine Kinase / Q000097:blood; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D000418:Albumins; C060687:Albunex; D003287:Contrast Media; D007527:Isoenzymes; D003402:Creatine Kinase