TY  - JOUR
A1  - ,  
T1  - Histological alterations of the human myocardium during minimally invasive direct coronary artery bypass operation
JO  - Eur. J. Anat.
SN  - 1136-4890
Y1  - 2007
VL  - 11
SP  - 169
EP  - 176
UR  - http://www.eurjanat.com/web/paper.php?id=07030169
KW  - biochemical marker
KW  - adult
KW  - aged
KW  - article
KW  - cell damage
KW  - clinical article
KW  - coronary artery blood flow
KW  - coronary artery bypass graft
KW  - electrocardiogram
KW  - electron microscopy
KW  - female
KW  - heart muscle biopsy
KW  - heart muscle cell
KW  - heart muscle ischemia
KW  - histopathology
KW  - human
KW  - human cell
KW  - human tissue
KW  - left anterior descending coronary artery
KW  - male
KW  - minimally invasive cardiac surgery
KW  - quantitative analysis
N2  - To study the ischaemia caused to myocardial cells during the Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) procedure, ten patients underwent surgical revascularization of the anterior descending artery using the MIDCAB technique. During the anastomosis, the left anterior descending (LAD) was snared with two sutures 4-0 prolene. The time of ischaemia was 13-22 min (mean 16.4 min). Three biopsies were taken from the anteroapical part of the left ventricle: a) Prior to the ischaemia b) At the end of the ischaemic period c) 25 minutes after blood flow had been restored. The degree of cellular and perivascular damage was studied by electron microscopy. Simultaneously, an electrocardiogram (ECG) was performed and the biochemical markers of myocardial ischaemia were measured. There were no deaths or myocardial infarctions. Slight ischaemic changes were found in all tissue samples before occlusion of the LAD. A semiquantitative analysis showed that a large percentage of myocytes (83.5-90%) in all phases were normal or only slight changes. A few myocytes (3-6%) were severely or irreversibly damaged. The morphometric analysis of mitochondrial oedema revealed no statistically significant differences. In conclusion, the MIDCAB technique can be applied for the surgical revascularization of the LAD without significant ischaemic changes to the myocardial cells.
ER  -