Myocardial consequences of coronary artery bypass graft surgery. The paradox of necrosis in areas of revascularization

Circulation
B H Bulkely, G M Hutchins

Abstract

Myocardial infarction after coronary artery bypass graft (CABG) surgery has been described clinically in up to 30% of patients but there is little morphologic information about the character and pathogenesis of the myocardial injury. We studied myocardium in the distribution of bypassed and nonbypassed coronary arteries for the presence of contraction band necrosis as compared to coagulation necrosis, in 58 autopsied patients who died less than 1 month after surgery. Operation related necrosis consisting of focal subendocardial contraction band necrosis was present to some degree in 48 (83%) patients. Regional transmural necrosis was present in 22 (38%) patients and was of two types. Contraction band necrosis occurred in 18 patients and was in the distribution of a patent bypassed coronary artery in 15 of them. Coagulation necrosis was found in four patients, and in each was in the distribution of a new graft-releated coronary artery occlusion. The results suggest that coronary artery reflow through widely patent grafts following the period of operative nonperfusion, rather than graft or intrinsic coronary artery occlusion, accounts for the majority of operation-related myocardial "infarcts" associated with CABG surgery. Thus, ...Continue Reading

References

Oct 6, 1975·The American Journal of Cardiology·R S Ross
Feb 1, 1974·Radiology·F J BonteE M Stokely
Sep 1, 1972·The Annals of Thoracic Surgery·R J FlemmaJ C Manley
Jan 1, 1974·The American Journal of Cardiology·G F BresnahanB E Sobel
Feb 1, 1974·The American Journal of Cardiology·J EspinozaS Dack
Nov 1, 1971·American Heart Journal·H N HultgrenW W Angell
Jan 31, 1969·Annals of the New York Academy of Sciences·R B JenningsJ P Kaltenbach

Citations

May 1, 1988·Cardiovascular Drugs and Therapy·J Schaper, W Schaper
Nov 1, 1978·World Journal of Surgery·C R HatcherJ A Kaplan
Mar 1, 1986·Basic Research in Cardiology·Dipak K DasS Lemeshow
Sep 1, 1983·The American Journal of Medicine·A G FreifeldB H Bulkley
Aug 31, 1984·Clinica Chimica Acta; International Journal of Clinical Chemistry·S Y FarahR N Sapsford
Jan 1, 1988·Free Radical Biology & Medicine·T J Gardner
Sep 1, 1992·Trends in Cardiovascular Medicine·B A Khaw, J Narula
Oct 4, 2000·The Annals of Thoracic Surgery·S M WemanU S Salminen
Jul 11, 1987·Lancet
Apr 1, 1983·Journal of the American College of Cardiology·J Schaper, W Schaper
Apr 1, 1984·Journal of the American College of Cardiology·D D WatersL Campeau
Jan 1, 1984·Journal of the American College of Cardiology·R G BrindisK Turley
Dec 5, 1998·Histopathology·A H Lee, P J Gallagher
Aug 29, 2009·Cardiovascular Research·Gerd Heusch
Jul 1, 1995·Journal of Cardiac Surgery·U Jain
Oct 1, 1979·British Heart Journal·P S RobinsonD J Coltart
Nov 1, 1979·British Heart Journal·E BodnarW H Wain
Nov 1, 1979·British Heart Journal·J A SbarbaroL Resnekov
Apr 1, 1984·British Heart Journal·C G McGregorD J Wheatley
Dec 1, 1987·The Journal of Clinical Investigation·J L ZweierM L Weisfeldt
Sep 6, 2007·The Tohoku Journal of Experimental Medicine·Zeynep EyiletenUmit Ozyurda
Dec 1, 1992·The British Journal of Radiology·A Jiménez-HeffernanA Mateo
Jan 17, 2008·Cardiology in the Young·Britt-Marie Ekman-JoelssonJan Sunnegårdh
Jul 21, 2010·The American Journal of Cardiology·Aslan T Turer, Joseph A Hill
Jan 30, 2007·Hematology/oncology Clinics of North America·Jakob Vinten-JohansenLynetta J Jobe
Apr 13, 2005·International Journal of Cardiology·A L MoensC J Vrints
Dec 1, 1995·Atherosclerosis·V M Maher
Oct 1, 1992·Journal of Cardiothoracic and Vascular Anesthesia·U Jain
May 1, 1987·Progress in Cardiovascular Diseases·N A Silverman, S Levitsky
May 1, 1987·Progress in Cardiovascular Diseases·J I Hoffman
May 1, 1985·Progress in Cardiovascular Diseases·S M Factor, E H Sonnenblick
Oct 1, 1979·The American Journal of Cardiology·H R BaurF L Gobel
Sep 1, 1983·The American Journal of Cardiology·C S RobertsR A Kloner
Jan 1, 1980·The Annals of Thoracic Surgery·C du CailarC M Grondin
Jul 1, 1983·The Journal of Surgical Research·S Okamatsu, A M Lefer
Jan 1, 1981·American Heart Journal·F D LoopW L Proudfit
Jan 1, 1987·Acta Anaesthesiologica Scandinavica·S KashimotoT Kumazawa
Dec 1, 1996·The Journal of Thoracic and Cardiovascular Surgery·G T HodakowskiR A Guyton
Nov 15, 1990·The American Journal of Cardiology·B van VliesA J Dunning
Dec 16, 1993·The American Journal of Cardiology·P ZardiniM Castelli
Oct 1, 1983·American Heart Journal·H OlthofK I Lie
Sep 1, 1982·The American Journal of Cardiology·A E BuxtonR N Edie
Jan 1, 1992·Renal Failure·M S GoligorskyR Johnson
Apr 29, 2014·American Heart Journal·Kevin R Bainey, Paul W Armstrong
Aug 1, 1980·The Annals of Thoracic Surgery·B H Bulkley
Jan 1, 1981·The Annals of Thoracic Surgery·H R BaurF L Gobel
Oct 1, 1979·American Heart Journal·B H Bulkley
May 20, 2017·Anesthesia and Analgesia·Robert H Thiele
Dec 1, 1981·Clinical Biochemistry·B C MortonW J Keon
Feb 1, 1982·Circulation·T W BauerG M Hutchins
Jul 1, 1978·Circulation·L I Bonchek
Mar 1, 1990·Clinical Cardiology·M C Fishbein
Mar 1, 1995·Basic Research in Cardiology·J I Hoffman
Jun 12, 2018·Angiology·Manolis S KallistratosAthanasios J Manolis

Related Concepts

Angina Pectoris
Coronary Artery Bypass Surgery
Blood Coagulation
Heart Injuries
Myocardial Infarction
Myocardium
Necrosis

Related Feeds

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.

Cardiology Journals

Discover the latest cardiology research in this collection of the top cardiology journals.