Importance of pulmonary artery perfusion in cardiac surgery.
OBJECTIVE
To investigate the importance of pulmonary artery perfusion in cardiac surgery.


METHODS
Prospective randomized study.


METHODS
University hospital.


METHODS
Patients undergoing cardiac surgery.


METHODS
Patients in whom the cross-clamp was applied only to the aorta were defined as group 1 (n = 11) and patients in whom the cross-clamp was applied to both the aorta and pulmonary artery were defined as group 2 (n = 11).


RESULTS
Tissue samples obtained from the lower lobe of the left lung before CPB, 20 minutes after cross-clamping, and 20 minutes after declamping were examined under light and electron microscopes. Electron microscopic examination revealed changes in the blood-air barrier, epithelial cells, pneumocytes, and basal membrane were more prominent in group 2. Changes in the leukocyte, neutrophil, and lymphocyte counts of blood samples obtained from the right atrium and right superior pulmonary vein before CPB and 5, 30, 60, and 90 minutes after the removal of clamp were also investigated. The transpulmonary difference was statistically significant at 5 and 30 minutes after declamping in group 1. In group 2, transpulmonary differences continued to be significant at 5, 30, 60, and 90 minutes after declamping. There was no difference between groups in terms of PaO(2)/F(I)O(2) ratio before CPB (group 1: 342.0 +/- 80.0 mmHg, group 2: 349.0 +/- 67.0 mmHg); however, a statistically significant difference was found between the groups 2 hours after declamping (group 1: 418.0 +/- 87.0 mmHg and group 2: 290.0 +/- 110.0 mmHg; p = 0.007).


CONCLUSIONS
Pulmonary artery perfusion was found to be important in cardiac surgery.
Ege
Turan
T
Department of Cardiovascular Surgery, Trakya University, Erdine, Turkey. turanege@ttnet.net.tr
Huseyin
Gülara
G
Yalcin
Omer
O
Us
Melih Hulusi
MH
Arar
Cavidan
C
Duran
Enver
E
D006348:Cardiac Surgical Procedures / Q000379:methods*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000379:methods; D006325:Heart Atria / Q000503:physiopathology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007958:Leukocyte Count; D007962:Leukocytes; D008168:Lung / Q000098:blood supply / Q000503:physiopathology / Q000648:ultrastructure; D008854:Microscopy, Electron; D008875:Middle Aged; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000503:physiopathology*; D011652:Pulmonary Circulation / Q000502:physiology*; D011667:Pulmonary Veins / Q000503:physiopathology; D015427:Reperfusion Injury / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors