Landsbergen, K. (2018) The distribution of cold blood cardioplegia in the right ventricle and the influence of coronary artery disease as determined by thermography. thesis, Medicine.
Full text available on request.Abstract
Background: cold blood cardioplegia (CBCP) is a cold, hyperkalemic solution that is used during cardiac surgery to stop the heart from beating and simultaneously protects the myocardial tissue from ischemic injury and reperfusion damage. According to previous research the distribution of cardioplegia to the right ventricle could be impeded by the presence of coronary artery disease (CAD) in the territory of the right coronary artery (RCA). Thermography using an infrared camera can measure epicardial temperature non-invasively and determine, based on temperature differences, if CBCP is or isn’t adequately distributed. Objective: to determine, according to thermography, to what degree CBCP is distributed to the right ventricle during cardiac surgery. Does the presence of CAD in the RCA territory influence epicardial temperature and does it result in a more heterogeneous cardioplegic area? Methods: observational pilot-/feasibility-study based on prospectively collected data from 12 patients who either electively underwent on-pump valve replacement surgery (no CAD present) or coronary artery bypass grafting (CABG) with or without valve replacement (CAD present). Results: there was a significant difference between the temperature at the start of CBCP administration and at the end for both the ‘valve replacement’ group (30.9 ± 0.5 versus 19.2 ± 1.1, p < 0.0001) and the ‘CABG’ group (30.9 ± 1.2 versus 22.2 ± 5.0, p < 0.001). No statistical significant difference in terms of epicardial temperature difference (11.6 ± 0.7 (valve replacement), 8.7 ± 4.4 (CABG), p = 0.496) and heterogeneity (1.9 ± 0.1 (valve replacement), 1.8 ± 0.6 (CABG), p = 0.660) between the two patient groups was found. Conclusion: Although statistical significance was not reached, the epicardial temperature in the ‘CABG’ group varied between patients with sometimes higher epicardial temperatures when compared to the ‘valve replacement’ group. Further investigation with a larger study population is needed to explore the influence of CAD on CBCP distribution.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and Scheeren, prof. dr. T.W.L. and Supervisor: prof. dr. T.W.L. Scheeren and Supervisor: dr. W.M. van den Bergh and Department: anesthesiology and Institution: Universitair Medisch Centrum Groningen, Groning |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:52 |
| Last Modified: | 25 Jun 2020 10:52 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1314 |
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