Author/Editor		Kirbiš, Janez
Title		Analiza viabilnosti miokarda pomoću segmentalnog epikardijalnog elektrokardiograma za vrijeme operacije na otvorenom srcu
Type		monografija
Place		Zagreb
Publisher		Sveučilište u Zagrebu, Medicinski fakultet
Publication year		1996
Volume		str. 42
Language		cro
Abstract		The purpose of the study was to examine the applicability of unipolar, segmental epicardial ECG during the open-heart surgery in order to determine the extent of the healthy and viable myocardium, which is potentially reversibly damaged. The studied group with unstable angina pesctoris consisted of 1 S patients (13 men, 2 women; 54,2 ± 9,3 ys; 10 patients class III-IV, 5 class IV NYHA), in which aortocoronary by-pass graft surgery was carried out on the basis of angina pectoris, proved myocardial ischemia and results of coronary angiography. All patients were treated in the Clinic for Cardiovascular Surgery, Ljubljana. Epicardial ECG was registered in the general anaesthesia immediately after pericardiotomy and one hour after myocardial revaskularization and after extracorporeal circulation was discontinued. Medtronic's temporary Temptron type electrode with a special olive was employed for determination of electrical potentials. Electričal potentials from the epicardial surface were always registered at the same place before and after operation. The height of R and S waves were measured and Index K (R/R+S) was calculated before (K1) and after (K2) revaskularization. By this approach we were able to achieve quantitative as well as qualitative data. Index K1 significantly improved from 53,9 ± 15,9 % to 75,5 ± 15,8 % in Index K2 (p=0,0007, ranges: 21-75 % vs 53-93%). The segmental epicardial ECG during the open-heart surgery proved to be simple, save, prognostic and useful for the operator. The significant improvement of Index K2 can be attributed to the favourable effcts of reperfusion on the acute as well as chronic myocardial ischemia.
Descriptors		ANGINA, UNSTABLE CORONARY DISEASE MYOCARDIAL REVASCULARIZATION ELECTROCARDIOGRAPHY INTRAOPERATIVE PERIOD EXTRACORPOREAL CIRCULATION PERICARDIUM CORONARY ANGIOGRAPHY CORONARY ARTERY BYPASS MYOCARDIAL STUNNING CREATINE KINASE CREATINE KINASE ISOENZYMES