Coronary Artery Disease Clinical Trial
Official title:
Early Cardioprotective Effect of Sevoflurane on Left Ventricular Performance During Coronary Artery Bypass Grafting on a Beating Heart
In vitro studies and in vivo animal experiments have shown that halogenated volatile anesthetics have a protective effect on the ischemic myocardium. In clinical settings however, anesthetic preconditioning may be of more interest. The aim of our study was to evaluate the cardioprotective effect of sevoflurane in patients undergoing off-pump coronary artery bypass surgery. We proposed that a cardioprotective effect of sevoflurane would save myocardial function, which we measured acceleration by esophageal Doppler and cardiac index with bolus thermodilution methods, both during brief ischemia and reperfusion.
Studies have been performed on human patients undergoing CABG surgery with cardiopulmonary
bypass (CPB). Only a few studies however have evaluated the effects of volatile anesthetics
during coronary artery bypass grafting on a beating heart (OPCABG) with conflicting results
as far as cardiac biomarker release is concerned.
Because CPB is known to have a profound impact on cardiac function, studies performed on
patients scheduled for OPCABG could evaluate more specifically the effects of the anesthetic
agents themselves. Patients undergoing OPCABG have a predictable and predefined ischemic
zone during surgery and represent an extremely interesting and safe model for the study of
ischemia and cardiac damage in humans.
Presently, there is still no consensus on the method of administration of volatile
anesthetics, including the time to begin administration, its duration, the dosage and
selection of volatile anesthetics.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind, Primary Purpose: Treatment
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