Danish Medical Bulletin - No. 4. November 2004. Vol. 51 Page 426.

ABSTRACT OF PhD DISSERTATION

Right heart assistance for coronary artery bypass grafting

Pia Hughes, MSc

PDF

This PhD dissertation was accepted by the Faculty of Health Sciences of the University og Aarhus, and defended on September 10, 2004.

Official opponents: Vibeke Hjortdal, Lars Willy Andersen and Henrik Ahn, Sweden.

Supervisors: J. Michael Hasenkam and Daniel A. Steinbrüchel.

Correspondence: Pia Hughes, Hjertecentret, Kirurgisk forskningsenhed, afsnit 9441, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.

Dan Med Bull 2004;51:426.

ABSTRACT

The studies were carried out in 1999-2001 at Clinical Institute (Former: Institute for Experimental Clinical Research) and at the department of Cardiac Thoracic and Vascular Surgery, Skejby Sygehus, Aarhus University Hospital, Denmark.

The PhD dissertation was compiled from three studies.

I: The aim was to test and describe the effect of right heart assistance for coronary artery bypass grafting in an animal experimental model. The heart was dislocated in order to allow access to the marginal arteries. The haemodynamics were monitored with and without application of right heart assistance.

II: Based on the positive results from study I, the aim of the second study was to implement right heart assistance technique in a clinical setting and compare the results with coronary bypass surgery performed with cardiopulmonary bypass in the same period at the same clinic. Fifty patients operated on with right heart assistance and 50 patients operated on with cardiopulmonary bypass were investigated.

III: The aim was to investigate whether low molecular weight heparin can prevent a suspected procoagulant state after coronary artery bypass grafting using right heart assistance.

The results are interpreted as follows. Coronary artery bypass surgery targeting the marginal arteries can be performed without the use of cardiopulmonary bypass. Stable haemodynamics can be achieved using right heart assistance (I and II). Approximate 20% of the patients needed additionally medical stimulation to maintain normal haemodynamic status during the surgical procedure (II). Right heart assistance for coronary artery bypass grafting is a real supplement to the variety of treatment methods that patients can be offered in heart surgery. The antithrombotic treatment strategy confined to acetylic salicylic acid only might be insufficient.
DANISH MEDICAL BULLETIN
The Danish Medical Bulletin reserves the right to store and publish articles (texts and illustra-tions), electronically too, eg on CD-ROM and the Internet. All rights reserved, ie prohibition against publication of texts and illustrations from the Danish Medical Bulletin. Rights can only be obtained by written acceptance from the author and editors and by quoting the Danish Medical Bulletin as source. Quotations of information from the Danish Medical Bulletin may not be published until after the publication of the issue in question and quotation of the source.