caa a22 4500 397495560 CHVBK 20180308164520.0 cr unu---uuuuu 161202e199502 xx s 000 0 eng 10.1016/S1010-7940(05)80024-7 doi (NATIONALLICENCE)oxford-10.1016/S1010-7940(05)80024-7 Myocardial and microvascular injury following coronary surgery and its attenuation by mode of reperfusion [Elektronische Daten] In 14 patients undergoing coronary surgery, repeated atrial biopsieswere obtained before and at the end of ischemia, and at 20 and 60 min ofreperfusion. In half of the patients reperfusion was initiated with anabrupt rise in blood temperature and pressure, in the other half with agradual rise. The biopsies were prepared for transmission electronmicroscopy and analyzed by stereological technique. In all biopsies,myocytic injury, as revealed by mitochondrial changes and intracellularedema, occurred following ischemia (P = 0.0003 and 0.007, respectively).The intracellular edema regressed following 20 min of reperfusion (P =0.008). The myocytic mitochondrial changes persisted during reperfusiontowards the end of the observation period (P = 0.0001). Interstitial edemaincreased following ischemia (P = 0.007) and persisted following 60 min ofreperfusion (P = 0.009). The capillary part was significantly reduced after20 min of reperfusion (P = 0.003), probably reflecting interstitial edema.Most changes were reversible in nature, although foci of irreversiblechanges were shown. In patients with a gradual start of reperfusion therewas a significant regression of interstitial edema (P = 0.005) at 60 minreperfusion compared to the patients with an abrupt start, where the samechanges seemed to persist or even increase. The study demonstrates that"reperfusion injury" occurs in human myocardium. It can be discerned from"ischemic" injury, and it may be reduced by a gentle mode ofreperfusion. © Springer-Verlag 1995 European Journal of Cardio-Thoracic Surgery Elsevier Science B.V. 9/2(1995-02), 83-89 1010-7940 9:2<83 1995 9 ejcts https://doi.org/10.1016/S1010-7940(05)80024-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1016/S1010-7940(05)80024-7 text/html Onlinezugriff via DOI NATIONALLICENCE 773 0- European Journal of Cardio-Thoracic Surgery Elsevier Science B.V 9/2(1995-02), 83-89 1010-7940 9:2<83 1995 9 ejcts Metadata rights reserved CC BY-NC-4.0 http://creativecommons.org/licenses/by-nc/4.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-oxford