Left ventricular-assisted myocardial revascularization favorably affects levels of circulating adhesion molecules and lung function.
BACKGROUND
We investigated whether the use of left ventricular-assisted (LVA) technique in beating heart myocardial revascularization would exert less impact on patients adhesion molecules and oxygenation index as compared with conventional cardiopulmonary bypass (CPB).


METHODS
Sixty-six consecutive patients undergoing myocardial revascularization were randomly assigned either to LVA (group A, 34 patients) or CPB (group B, 32 patients). Adhesion molecules and oxygenation indexes were measured at baseline and at various time points postoperatively.


RESULTS
Pre-operative clinical and demographic data did not differ between the 2 groups. The 2 groups were also similar with respect to mortality, number of grafts performed, duration of extracorporeal circulation, and need for inotropes. However, postoperatively patients treated with LVA had a reduced levels of adhesion molecules compared with patients treated with CPB, as indicated by a significant difference in endothelial leukocyte adhesion molecule-1 (P = .002), intercellullar adhesion molecule-1 (P = .0001), and vascular cell adhesion molecule-1 (P = .004). The oxygenation index at 1 (P = .04) and 3 hours (P = .03) postoperatively was better in the LVA group than in the CPB group.


CONCLUSIONS
Patients undergoing beating heart myocardial revascularization with LVA show reduced levels of adhesion molecules and better oxygenation index than patients treated with CPB.
Stassano
Paolo
P
Cardiac Surgery Unit, University Federico II, School of Medicine, Naples, Italy.
Di Tommaso
Luigi
L
Monaco
Mario
M
Mannacio
Vito Antonio
VA
Mottola
Michele
M
La Marca
Agostino
A
Pepino
Paolo
P
Vosa
Carlo
C
D000368:Aged; D002315:Cardiopulmonary Bypass / Q000379:methods*; D015815:Cell Adhesion Molecules / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood* / Q000503:physiopathology / Q000601:surgery*; D009204:Myocardial Revascularization; D011659:Pulmonary Gas Exchange / Q000502:physiology; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome
D015815:Cell Adhesion Molecules