Evaluierung der Troponin-I-Freisetzung in der kardialen Lymphe bei herzchirurgischen Eingriffen unter Einsatz des extrakorporalen Kreislaufes

Extracorporeal circulation (ECC) induces a systemic inflammatory response and a perioperative myocardial damage (PMD) leading to postoperative myocardial dysfunction. The cardiac lymphatic system is because of its origin in the interstitial space of the heart, more sensitive than arterial and coronary sinus (CS) blood in reflecting the physiological state of the myocardium. After detailed studies of the cardiac lymphatics we observed 3 anatomic variations and classified them as right drainage (51,4%), intermediate drainage (40%) and left drainage type (16,7%). A new developed Inclusion-technique of the main efferent lymph trunk lead to a cannulation success rate of 65,4%. Further, we studied in 21 pigs the ECC induced PMD and the influence of temperature on perioperative cTnI release and cardiac lymph flow. Base lymph flow was 3,4 ml/h and tended towards zero after aortic clamping. After aortic declamping and postoperatively lymph flow reached 2-3 foldhigher levels in the normo- and deep hypothermic group. Postoperative cTnI concentration in lymph was 100-500 fold higher than in CS and arterial blood showing the close origin to the myocardium. The postoperative elevation of cTnI concentration imply a PMD caused by the ECC, which was less profound in the moderate hypothermia group, who had the smallest need for catecholamine support. Finally cardiac lymph studies can show PMD adequately and reflects the myocardium more sensitive than arterial and CS blood.

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2001

Author dc:creator

• Liakopoulos, Oliver Johannes

Contributors dc:contributor

• Messmer, Bruno J.

• info:eu-repo/classification/ddc/610
• Medizin

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

ger

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-118640%22

OAI record oai:identifier

https://publications.rwth-aachen.de/oai2d?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Apublications.rwth-aachen.de%3A56546