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SMART 2004 - Milan, May 12-14, 2004
Guarracino F., Doroni L., Cariello C., Baldassarri R., Vullo C.
U.O.C. Anestesia e Rianimazione Cardiotoracica, Azienda Ospedaliera Universitaria Pisana, Pisa
Aim. Anaesthetics may have protective effect against myocardial ischemia. We aimed to investigate if sevoflurane administration could exert myocardial protection during following coronary occlusion in patients with coronary artery disease.
Methods. a) Experimental design: prospective, randomized study. b) Setting: University Hospital, cardiac surgical operative theatre. c) Patients: 42 patients with coronary artery disease, scheduled to undergo coronary surgery. Inclusion criteria: severe coronary stenosis of anterior descending coronary artery; no collateral flow on angiography; at least two normokinetic segments in the myocardial region supplied by the vessel being bypassed. Patients were randomized to receive (group S) or not (group C) sevoflurane administration for 15 min just before coronary occlusion. d) Interventions: Transoesophageal Tissue Doppler echocardiographic examination of myocardial systolic and early diastolic velocities in both groups basally and 60 s after coronary occlusion by the surgeon. e) Measures: systolic and early diastolic velocities were registred by Tissue Doppler from a long-axis view of the interventricular septum or the anterior wall of the left ventricle.
Results. In group C a significant reduction of systolic and diastolic intramyocardial velocities was found during myocardial ischemia due to coronary occlusion.
Conclusion. Treatment with sevoflurane before coronary occlusion seem effective in reducing functional myocardial impairment due to ischemia.