Navigation Links
Restricting Blood Flow May Help Heart Bypass Patients

The technique reduces levels of protein linked to poor surgery results, study says

THURSDAY, Aug. 16 (HealthDay News) -- In a potentially significant discovery for heart bypass patients, British researchers are reporting that limiting blood flow to an arm before surgery produced better results in a small trial of patients.

Restricting blood flow before surgery reduced levels of troponin T, a cardiac protein that is released into the bloodstream after injury to the heart and is associated with poor outcomes after surgery, the researchers said.

"If you remotely precondition the heart before surgery, you get significant protection," said study researcher Dr. Derek Yellon, of University College London's Hatter Cardiovascular Institute. "You can significantly reduce troponin T in patients undergoing bypass surgery."

"Remote preconditioning is a phenomena in which, if one deprives the blood supply to an organ or tissue, other than the heart, that initiates a protective mechanism on the heart," added study lead author Dr. Derek J. Hausenloy, also from the Hatter Cardiovascular Institute.

The findings are published in the Aug. 18 issue of The Lancet.

Heart bypass surgery is done to reroute -- or "bypass" -- blood around clogged arteries to improve blood flow and oxygen to the heart, according to the American Heart Association.

In the trial, the British researchers restricted blood supply to the heart by restricting blood flow in an arm. Yellon and Hausenloy studied 57 patients undergoing coronary artery bypass surgery. Twenty-seven of the patients underwent heart preconditioning -- restrictions of blood flow -- before the operation.

Preconditioning consisted of three, five-minute cycles of restricting blood flow in one arm by inflating a blood pressure cuff that acted like a tourniquet. Between each cycle, the cuff was deflated.

Before and after surgery, the researchers measured the blood levels of troponin T in all patients. They found that levels of the protein were reduced by 43 percent among patients who had undergone preconditioning, compared with those who hadn't.

"If you can have a noninvasive technique that can reduce by 43 percent the amount of injury sustained by the heart during bypass surgery, then you can improve the morbidity and mortality of patients," Hausenloy said.

More study is needed to see if the technique actually improves clinical outcomes, Hausenloy said. "If this can be shown, it may warrant a change in clinical practice in all patients undergoing bypass surgery," he added.

Another heart expert agrees that if this concept is workable, it could represent a major advance in heart-bypass surgery.

"Revascularization, with angioplasty or bypass surgery, carries risk of heart muscle damage, measured in the study by troponin release," said Dr. Henry Purcell, of the Royal Brompton Hospital in London, and co-author of an accompanying editorial in the journal. "We need to minimize these risks in cardiac and non-cardiac surgery."

"We clearly need more data, and the current team is designing outcome studies to see if this protection translates into clinical benefits," Purcell said.

In another report in the same issue of the journal, South Korean researchers showed that use of the painkiller celecoxib (Celebrex) after implanting a stent to open blocked arteries in people with coronary artery disease is safe and might reduce the need for repeat procedures.

Dr Hyo-Soo Kim, of Seoul National University Hospital, and colleagues studied 274 patients, all of whom were given 100 milligrams of aspirin and 75 milligrams of Plavix -- a drug designed to prevent blood clots -- a day. In addition, 136 were randomly assigned to receive celecoxib before and after the procedure.

"These data suggest that the adjunctive use of celecoxib for six months after stent implantation in patients with coronary artery is safe," the researchers wrote.

In addition, they say that unlike another cox-2 inhibitor, Vioxx, celecoxib does not increase the risk of heart attack. "Administration of celecoxib for six months does not seem to increase the risk of adverse cardiac events in the intermediate term when used with dual anti-platelet therapy," they wrote.

However, another accompanying journal editorial warned that clinical trials suggest that long-term use of celecoxib may increase the risk of heart attack.

More information

To learn more about bypass surgery, visit the American Heart Association.

SOURCES: Derek Yellon, M.D., and Derek J. Hausenloy, M.D., Ph.D., both Hatter Cardiovascular Institute, University College London; Henry Purcell, M.D., Royal Brompton Hospital, London; Aug. 18, 2007, The Lancet


Copyright©2007 ScoutNews,LLC.

Related medicine news :

1. New Zealand Doctors for Restricting Trampoline Sales
2. Recommendations for Treatment of Blood Pressue
3. Blood Cells Capable of Regenerating Liver
4. Infant receives first bloodless liver transplant
5. Spouses and other partners lower blood pressure says new research
6. H2O - a cure for low blood pressure
7. Uncontrolled blood pressure
8. Nitric oxide involved in high blood pressure
9. Recouping blood flow after a stroke
10. Way to monitor blood pressure
11. Blood clots likely in long travel
Post Your Comments:
(Date:11/30/2015)... , ... November 30, 2015 , ... ... (ASI) as their exclusive channel partner for the Nutraceutical Specialties products into oral ... the US, effective immediately. , “We are pleased to announce our expanded ...
(Date:11/30/2015)... ... 2015 , ... Medicalis, a leading developer of enterprise-scale Imaging ... (RSNA) annual meeting, being held November 29 – December 3, 2015, that its ... company has completed installations for Integrated Delivery Network (IDN) customers such as WellSpan, ...
(Date:11/30/2015)... ... November 30, 2015 , ... Holcomb – Kreithen Plastic ... surgery practices in Florida, is proud to announce that Dr. Joshua Kreithen, one ... Ethicon Inc., a Johnson & Johnson Company. , Ethicon is a global medical ...
(Date:11/30/2015)... ... November 30, 2015 , ... Insightra Medical, Inc. and ... Mesh technology for soft tissue repair in the US via Insightra’s national direct ... surgical mesh intended to support and reinforce soft tissue for 6-9 months before ...
(Date:11/30/2015)... ... ... TransPack Volume 6 features 30 customizable transitions created exclusively for use within ... with blur & drop shadow options. Utilize the controls in the inspector window ... the next with TransPack's easily customizable styles. , TransPack Volume 6 features ...
Breaking Medicine News(10 mins):
(Date:11/30/2015)... , Nov. 30, 2015  Hanger, Inc. (NYSE: ... restatement of the terms of its previously announced consent ... to its $200,000,000 aggregate principal amount 7⅛% Senior Notes ... (i) the consent fees payable pursuant to the Consent ... Notes and (iii) the expiration date of the Consent ...
(Date:11/30/2015)...  Precision Image Analysis Inc. (PIA), a leading ... a dramatic expansion of its capabilities as a ... ISO-9001:2008 certification for its Quality Management System, PIA ... and procedures. This expansion enables PIA to support ... Lab services include design and optimization of protocols, ...
(Date:11/30/2015)... and REHOVOT, Israel , Nov. 30, ... company focused on acquiring and developing innovative therapies for ... appointment of Keith A. Katkin as chairman ... J. Flesher , chief executive officer for OticPharma, Ltd.  ... organizations.  As chairman, he will be able to share ...
Breaking Medicine Technology: