Effects of purified poloxamer 407 gel on vascular occlusion and the coronary endothelium

Boodhwani, Munir; Feng, Jun; Mieno, Shigetoshi; Ramlawi, Basel; Sodha, Neel; Clements, Richard; Sellke, Frank W.
May 2006
European Journal of Cardio-Thoracic Surgery;May2006, Vol. 29 Issue 5, p736
Academic Journal
Abstract: Objective: Vascular occlusion during off-pump coronary surgery often results in sub-optimal visualization and endothelial damage of the target vessel. We have previously reported the safety of purified poloxamer 407, a gel with reverse thermosensitive properties, in a model of off-pump coronary occlusion. The aim of this study was to evaluate different gel concentrations and their effects on coronary occlusion time, myocardial contractility, endothelial function, and markers of myocardial injury and apoptosis. Methods: Yorkshire swine (30–35kg) underwent sternotomy and mid-LAD occlusion using either microvascular clamps (n =6) or varying quantities of three different concentrations (20%; n =6, 22.5%; n =3, and 25%; n =3) of purified poloxamer 407 gel. Distal LAD flow, left ventricular pressure, and in vitro microvascular reactivity were assessed. Molecular markers of myocardial injury and apoptosis were assessed using Western blotting. Results: Duration of ischemia correlated significantly with the amount of injected gel for the 20% and 22.5% formulations (Spearman r =0.64, p =0.02 and r =0.85, p =0.03, respectively) but not for the 25% gel (r =0.22, p =0.66). There were no significant differences in LV contractility (maximum+dp/dt) (p =0.86) as well as LAD flow (p =0.25) during reperfusion in the four groups. Microvessel relaxation to adenosine diphosphate in the ischemic territory was impaired with higher concentrations of the gel, 22.5% (−14.8±7.5% vs control at 10−5 mol/L, p <0.05) and 25% gel (−24.0±7.6% vs control at 10−5 mol/L, p <0.001) but not with the 20% gel. Endothelium-independent relaxation to sodium nitroprusside was preserved in all groups. Cleaved poly(ADP-ribose) polymerase, a marker of myocardial injury and apoptosis, was elevated in the ischemic myocardium in all groups (p =0.02 vs non-ischemic myocardium) with no significant differences between the groups (p =0.70). Phosphorylation of Bad, an anti-apoptotic protein, was significantly reduced in the ischemic territory (p =0.04). No changes were observed in other markers of myocardial apoptosis. Conclusions: Purified poloxamer 407 gel is effective for temporary coronary vascular occlusion. Coronary artery occlusion time is related to gel concentration and the quantity of gel injected. The higher gel concentrations may cause endothelial dysfunction of the distal vasculature and therefore should be avoided.


Related Articles

  • Human cardiac tissue in a microperfusion chamber simulating extracorporeal circulation - ischemia and apoptosis studies. Usta, Engin; Renovanz, Mirijam; Mustafi, Migdat; Ziemer, Gerhard; Aebert, Hermann // Journal of Cardiothoracic Surgery;2010, Vol. 5, p1 

    Background: After coronary artery bypass grafting ischemia/reperfusion injury inducing cardiomyocyte apoptosis may occur. This surgery-related inflammatory reaction appears to be of extreme complexity with regard to its molecular, cellular and tissue mechanisms and many studies have been...

  • Cardioprotective effects of KB-R7943, a novel inhibitor of Na+/Ca2+ exchanger, on stunned myocardium in anesthetized dogs. Yoshitomi, Osamu; Akiyama, Daiji; Hara, Tetsuya; Sungsam Cho; Tomiyasu, Shiro; Sumikawa, Koji // Journal of Anesthesia;2005, Vol. 19 Issue 2, p124 

    Examines the cardioprotective effects of KB-R7943 (KBR), a novel inhibitor of Na+/Ca2+ exchanger, on stunned myocardium in anesthetized dogs. Production of stunned myocardium by occlusion of left anterior descending coronary artery; Evaluation of regional myocardial contractility with segment...

  • Two-vessel chronic total occlusion. Complete percutaneous revascularisation. Dębski, Artur; Tyczyński, Paweł; Opolski, Maksymilian P.; Kłopotowski, Mariusz; Karcz, Maciej A.; Witkowski, Adam // Advances in Interventional Cardiology;2014, Vol. 10 Issue 4, p320 

    Little is known about the success rate of second attempts to open chronic total occlusions. Two-vessel occlusion makes the procedure is even more challenging. Thus, embarking on complete percutaneous revascularization of such lesions requires adequate experience, especially after first...

  • A 66-year-old woman with prolonged chest pain.  // Heart;Apr2015, Vol. 101 Issue 8, p636 

    The article presents a case study of 6-year-old woman with prolonged chest pain doing rest. It informs that electrocardiography (ECG) has shown poor R-wave progression with T-wave inversion anteriorly. It suggest for cardiac surgery for myocardial bridging with superimposed obstructive...

  • Coronary-aortic interaction during ventricular isovolumic contraction. Houwelingen, Marc; Merkus, Daphne; te Lintel Hekkert, Maaike; Dijk, Geert; Hoeks, Arnold; Duncker, Dirk // Medical & Biological Engineering & Computing;Aug2011, Vol. 49 Issue 8, p917 

    In earlier work, we suggested that the start of the isovolumic contraction period could be detected in arterial pressure waveforms as the start of a temporary pre-systolic pressure perturbation (AIC, start of the Arterially detected Isovolumic Contraction), and proposed the retrograde coronary...

  • Extracellular volume fraction in coronary chronic total occlusion patients. Chen, Yin; Zhang, Wei; Yang, Shan; Yun, Hong; Deng, Sheng; Fu, Cai; Zeng, Meng; Jin, Hang; Guo, Liang // International Journal of Cardiovascular Imaging;Aug2015, Vol. 31 Issue 6, p1211 

    (1) To assess extracellular volume fraction (ECV) and regional systolic function in patients presenting with coronary chronic total occlusion (CTO) in areas without significant late gadolinium enhancement (LGE), and (2) to investigate the correlation between angiography collateral flow and ECV...

  • Procalcitonin in patients undergoing cardiopulmonary bypass in open heart surgery-first results of the Procalcitonin in Heart Surgery study (ProHearts). Loebe, M.; Locziewski, S.; Brunkhorst, F. M.; Harke, C.; Hetzer, R. // Intensive Care Medicine;Mar2000 Supplement 2, Vol. 26, pS193 

    Objective: To investigate procalcitonin (PCT) levels in patients undergoing cardiopulmonary bypass (CPB) in order to assess the prevalence and prognostic capacity of elevated PCT levels following CPB in open heart surgery.Design: prospective observational study in...

  • Does Gender Influence the Patency of Infrainguinal Bypass Grafts? Alpagut, Ufuk; Ugurlucan, Murat; Banach, Maciej; Mikhailidis, Dimitri P.; Dayioglu, Enver // Angiology;Jun/Jul2008, Vol. 59 Issue 3, p278 

    Infrainguinal revascularization is an effective method of treatment for femoropopliteal!tibial occlusive diseases. However, these bypass grafts are prone to stenosis. In this retrospective study, the authors investigate the association of gender with patency of infrainguinal bypass grafts. The...

  • The Poohsticks phenomenon. Knight, Robert // BMJ: British Medical Journal (International Edition);12/18/2004, Vol. 329 Issue 7480, p1432 

    Presents a study to investigate the hypothesis regarding transient ischaemic attacks and how they occur. Description of the "Poohsticks" phenomenon; Use of the Poohsticks game in researching the way atheroembolism move when released into the bloodstream; How emboli react similarly to pine cones...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics