Analysis of the myocardial metabolism by microdialysis during open beating heart surgery.
OBJECTIVE
Microdialysis allows the in vivo biochemical analysis of interstitial fluids. Our aim was to reveal in vivo reliable data of the myocardium during open beating heart surgery.


METHODS
In ten patients undergoing routine beating coronary artery bypass grafting a microdialysis catheter was inserted into the left ventricle. Measurements were performed up to 45 min after anastomosis. Data were retrospectively compared with standard on-pump procedures.


RESULTS
The myocardial lactate remained stable during anastomosis, followed by a significant decrease of lactate after revascularisation. Myocardial glucose levels showed a slight decrease, followed by a significant increase after revascularisation. Myocardial purines showed a slight increase during anastomosis, followed by a sharp decrease during reperfusion period.


CONCLUSIONS
In contrast to on-pump procedures myocardial lactate and purines showed less increasing trend during the ischemic period, while myocardial glucose remained stable as a sign of preserved tissue blood flow. Myocardial microdialysis showed different values compared to the elective on-pump CABG and previous animal studies. This technique allows bedside monitoring of biochemical changes, suggesting its possible role as a clinical monitoring tool.
Pöling
Jochen
J
Department of Cardiac Surgery, Schüchtermann-Klinik Bad Rothenfelde, Germany. jochen.poeling@freenet.de
Leptien
Alexander
A
Klaus
Stephan
S
Rees
Wolfgang
W
Kraatz
Ernst
E
Wiebe
Karsten
K
Bahlmann
Ludger
L
D000368:Aged; D006328:Cardiac Catheterization; D002318:Cardiovascular Diseases / Q000601:surgery*; D047549:Coronary Artery Bypass, Off-Pump; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000378:metabolism*; D008297:Male; D017551:Microdialysis; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods; D009206:Myocardium / Q000378:metabolism*; D019289:Pyruvic Acid / Q000378:metabolism; D012189:Retrospective Studies; D013997:Time Factors
D019344:Lactic Acid; D019289:Pyruvic Acid