+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Serum S-100 protein release and neuropsychologic outcome during coronary revascularization on the beating heart: a prospective randomized study



Serum S-100 protein release and neuropsychologic outcome during coronary revascularization on the beating heart: a prospective randomized study



Journal of Thoracic and Cardiovascular Surgery 119(1): 148-154



Our purpose was to establish whether coronary revascularization on the beating heart without cardiopulmonary bypass is less harmful to the brain than conventional surgery with cardiopulmonary bypass as indicated by measures of cognitive function or by changes in serum concentrations of S-100 protein, a recognized biochemical marker of cerebral injury. We conducted a prospective randomized trial in which the assessors of the outcome measures were blind to the treatment received. Sixty patients without known neurologic abnormality, undergoing coronary revascularization, were prospectively randomized to 1 of 2 groups: (1) cardiopulmonary bypass (32 degrees C-34 degrees C) and cardioplegic arrest (on pump) with intermittent antegrade warm blood cardioplegia or (2) surgery on the beating heart (off pump). Neuropsychologic performance was assessed before and 12 weeks after the operation. Serum S-100 protein concentration was measured at intervals up to 24 hours after the operation. The groups had similar preoperative characteristics. There were no deaths or major neurologic complications in either group, nor was there any difference between groups in the chosen index of neurologic deterioration. Serum S-100 protein concentrations were higher in the on-pump group at 30 minutes, but any such difference between groups had disappeared 4 hours later. The extent of the changes in S-100 protein was unrelated to the index of neuropsychologic deterioration. The changes in S-100 protein concentration suggest that the brain and/or blood-brain barrier may be more adversely affected during coronary artery surgery with cardiopulmonary bypass than during surgery on the beating heart, but that this may not be reflected in detectable neuropsychologic deterioration at 12 weeks.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 047345116

Download citation: RISBibTeXText

PMID: 10612774


Related references

Serum S-100 protein release and neuropsychologic outcome during coronary revascularization on the beating heart: A prospective randomized study. Journal of Thoracic and Cardiovascular Surgery 119(1): 148-154, 2000

A prospective randomized study to evaluate splanchnic hypoxia during beating-heart and conventional coronary revascularization. EuropeanJournalofCardio-ThoracicSurgery23(6):917, 2003

A prospective randomized study to evaluate stress response during beating-heart and conventional coronary revascularization. Annals of Thoracic Surgery 78(2): 506, 2004

Beating heart revascularization with or without cardiopulmonary bypass: evaluation of inflammatory response in a prospective randomized study. Journal of Thoracic and Cardiovascular Surgery 127(6): 1624-1631, 2004

Beating versus arrested heart revascularization: evaluation of myocardial function in a prospective randomized study. European Journal of Cardio-Thoracic Surgery 15(5): 685-690, 1999

Late outcome of reoperative coronary revascularization on the beating heart. Heart Surgery Forum 4(1): 69-73, 2001

Predictors of atrial fibrillation after conventional and beating heart coronary surgery: A prospective, randomized study. Circulation 102(13): 1530-1535, 2000

A prospective randomized study to evaluate the renoprotective action of beating heart coronary surgery in low risk patients. European Journal of Cardio-Thoracic Surgery 22(1): 118-123, 2002

The effects of cardiopulmonary bypass temperature on neuropsychologic outcome after coronary artery operations: A prospective randomized trial. Journal of Thoracic and Cardiovascular Surgery 112(4): 1036-1045, 1996

Reduced postoperative blood loss and transfusion requirement after beating-heart coronary operations: a prospective randomized study. Journal of Thoracic and Cardiovascular Surgery 121(4): 689-696, 2001

Beating versus arrested heart coronary revascularization: evaluation by cardiac troponin I release. Annals of Thoracic Surgery 77(6): 2051-2055, 2004

A prospective, randomized study of the effects of prostacyclin on neuropsychologic dysfunction after coronary artery operation. Journal of Thoracic and Cardiovascular Surgery 93(4): 609-615, 1987

On-pump beating heart coronary revascularization: Is it valid for emergency revascularization?. Annals of Saudi Medicine 35(2): 133-137, 2015

Coronary revascularization on beating heart. Orvosi Hetilap 141(40): 2183-2186, 2000