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Coronary flow before and after surgical versus device closure of atrial septal defect.

Aburawi, Elhadi LU ; Berg, Ansgar LU and Pesonen, Erkki LU (2009) In International Journal of Cardiology 135. p.14-20
Abstract
BACKGROUND: Cardiopulmonary bypass (CPB) affects coronary flow after the operation. Surgical as compared to device closure of atrial septal defect (ASD) serves as a good model to clarify the effects of surgery with CPB on coronary flow. METHODS: Coronary flow parameters were determined by transthoracic Doppler echocardiography before and after ASD closure. Thirteen children underwent surgery on CPB and fourteen children had device closure of their ASD under interventional cardiac catheterisation. Fourteen age-matched healthy controls were studied. RESULTS: Left ventricular fractional shortening increased and cardiac output increased after the device closure but there were no significant changes after the surgery. After the surgery the mean... (More)
BACKGROUND: Cardiopulmonary bypass (CPB) affects coronary flow after the operation. Surgical as compared to device closure of atrial septal defect (ASD) serves as a good model to clarify the effects of surgery with CPB on coronary flow. METHODS: Coronary flow parameters were determined by transthoracic Doppler echocardiography before and after ASD closure. Thirteen children underwent surgery on CPB and fourteen children had device closure of their ASD under interventional cardiac catheterisation. Fourteen age-matched healthy controls were studied. RESULTS: Left ventricular fractional shortening increased and cardiac output increased after the device closure but there were no significant changes after the surgery. After the surgery the mean diameter of left anterior descending coronary artery increased from 1.7+/-0.6 to 2.1 +/-0.4 mm (p=0.03), the peak flow velocity in diastole (PFVd) from 48+/-10 to 70+/-12 cm/s (p=0.0001) and basal blood flow (BF) from 62+/-18 to 105+/-35 ml/min (p=0.0001). Flow parameters in the right coronary artery increased similarly. In contrast, all coronary flow parameters decreased substantially after catheter interventions, but still remained significantly elevated as compared with controls. CONCLUSIONS: Surgery with cardiopulmonary bypass but not the device closure affects coronary flow beyond the pure effects of anatomical correction. Cardiac output increases after the device closure. The reported decrease of coronary flow reserve is obviously due to increased basal coronary flow. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
International Journal of Cardiology
volume
135
pages
14 - 20
publisher
Elsevier
external identifiers
  • wos:000266502700003
  • pmid:18597874
  • scopus:67349216619
ISSN
0167-5273
DOI
10.1016/j.ijcard.2008.03.046
language
English
LU publication?
yes
id
14bb8499-c653-4e43-b5d4-46082f2b4f72 (old id 1181602)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18597874?dopt=Abstract
http://www.sciencedirect.com/science/article/pii/S0167527308004725
date added to LUP
2008-08-06 15:53:39
date last changed
2017-12-10 04:44:23
@article{14bb8499-c653-4e43-b5d4-46082f2b4f72,
  abstract     = {BACKGROUND: Cardiopulmonary bypass (CPB) affects coronary flow after the operation. Surgical as compared to device closure of atrial septal defect (ASD) serves as a good model to clarify the effects of surgery with CPB on coronary flow. METHODS: Coronary flow parameters were determined by transthoracic Doppler echocardiography before and after ASD closure. Thirteen children underwent surgery on CPB and fourteen children had device closure of their ASD under interventional cardiac catheterisation. Fourteen age-matched healthy controls were studied. RESULTS: Left ventricular fractional shortening increased and cardiac output increased after the device closure but there were no significant changes after the surgery. After the surgery the mean diameter of left anterior descending coronary artery increased from 1.7+/-0.6 to 2.1 +/-0.4 mm (p=0.03), the peak flow velocity in diastole (PFVd) from 48+/-10 to 70+/-12 cm/s (p=0.0001) and basal blood flow (BF) from 62+/-18 to 105+/-35 ml/min (p=0.0001). Flow parameters in the right coronary artery increased similarly. In contrast, all coronary flow parameters decreased substantially after catheter interventions, but still remained significantly elevated as compared with controls. CONCLUSIONS: Surgery with cardiopulmonary bypass but not the device closure affects coronary flow beyond the pure effects of anatomical correction. Cardiac output increases after the device closure. The reported decrease of coronary flow reserve is obviously due to increased basal coronary flow.},
  author       = {Aburawi, Elhadi and Berg, Ansgar and Pesonen, Erkki},
  issn         = {0167-5273},
  language     = {eng},
  pages        = {14--20},
  publisher    = {Elsevier},
  series       = {International Journal of Cardiology},
  title        = {Coronary flow before and after surgical versus device closure of atrial septal defect.},
  url          = {http://dx.doi.org/10.1016/j.ijcard.2008.03.046},
  volume       = {135},
  year         = {2009},
}