Objective To explore perioperative outcomes of coronary artery bypass grafting （CABG） using the radialartery as the second arterial graft. Methods Clinical data of 175 consecutive patients undergoing off-pump coronary artery bypass grafting （OPCAB） in General Hospital of Shenyang Military Command from August 2011 to April 2012 were retrospectively analyzed. All the 175 patients were divided into two groups. There were 75 patients including 49 male and 26 female patients with their age of 56.8±8.2 years in group 1，who received radial artery as a graft vessel. There were 100patients including 66 male and 34 female patients with their age of 57.7±8.1 years in group 2，who received great saphenousvein but not radial artery as the graft vessel. The use of left internal mammary artery as a graft vessel was 100% in both groups. Perioperative cardiovascular events and other clinical results were compared between the two groups. Results All the patients survived OPCAB and there was no 30-day death. There was no statistical difference in operation time，thoracic drainage within the first 24 hours after surgery or postoperative hospital stay between the two groups（P＞0.05）. Length of postoperative ICU stay and mechanical ventilation time of group 1 were shorter than those of group 2，although the differencewas not statistically significant. The percentage of patients receiving prolonged postoperative inotropic therapy of group 2 was higher than that of group 1 ［16% （16/100） vs. 12% （9/75）］，although the difference was not statistically significant. Postoperatively，there was no patient in group 1 who had new-onset myocardial ischemia or received intra-aortic balloon pump （IABP） support for hemodynamic instability. In group 2，3 patients had new-onset myocardial ischemia and 2 patientsreceived IABP support after OPCAB. Conclusion Radial artery can partly replace great saphenous vein as a graft vesselfor OPCAB，which does not increase the risk of perioperative cardiovascular events but is beneficial for postoperativerecovery to some degree. Radial artery can be more extensively used in CABG.
Abstract: Objective To observe the influence of various methods of cerebral protection during deep hypothermic circulatory arrest (DHCA ) on S-100 protein. Methods Eighteen dogs were randomly and equally divided into three groups: the deep hypothermic circulatory arrest (DHCA group ) , the DHCA with retrograde cerebral perfusion (DHCA + RCP group ) , and the DHCA with intermittent antegrade cerebral perfusion (DHCA + IACP group ). Upon interruption of cardiopulmonary bypass (CPB) , the nasopharyngeal temperature was slowly lowered to 18℃, before CPB was discontinued for 90 minutes, after 90 minutes, CPB was re-established and the body temperature was gradually restored to 36℃, then CPB was terminated. Before the circulatory arrest, 45min, 90min after the circulatory arrest and 15min, 30min after re-established of CPB, blood samples were drawn from the jugular veins fo r assay of S-100 protein. Upon completion of surgery, the dogs was sacrificed and the hippocampus was removed from the brain, properly processed for examination by transmission electron microscope for changes in the ultrastructure of the brain and nerve cells. Results There was no significant difference in the content of S-100 protein before circulatory arrest among all three groups (P gt; 0.05). After circulatory arrest, DHCA and DHCA +RCP group showed an significant increase in the content of S-100 protein (P lt; 0.01). There was no significant difference in the content of S-100 protein after circulatory arrest in DHCA + IACP group. Conclusion Cerebral ischemic injuries would occur if the period of DHCA is prolonged. RCP during DHCA would provide protection for the brain to some extent, but it is more likely to cause dropsy in the brain and nerve cells. On the other hand IACP during DHCA appears to provide better brain protection.