Intramyocardial troponin-T monitoring with microdialysis in coronary artery bypass surgery

Vittorio Mantovani, Charles Kennergren, Eva Berglin, Remigio Moratti, Peter Lönnroth, Anders Hamberger, Mario Viganó

Research output: Contribution to journalArticlepeer-review

Abstract

Objective - To investigate the time course of troponin-T release into the extracellular fluid of the myocardium and to distinguish between a rise in troponin-T due to implantation trauma and an increase due to cardiac arrest during coronary surgery. Design - Microdialysis probes were implanted in the heart of seven patients soon after sternotomy. Troponin-T was measured in the microdialysates and in peripheral blood from 3 h before to 24 h after heart arrest. Results - The troponin-T concentration in the microdialysates increased immediately after probe implantation and decreased to baseline within 70 min. This early peak is interpreted to reflect a local trauma. Three hours after cross-clamp release, a second peak of microdialysate troponin-T was recorded; 50 times higher than in serum. Eight to 24 h later a third peak occurred in five patients. Serum troponin-T was below the detection level at the beginning of the operation but increased linearly during the first 3 h of reperfusion and remained at that level thereafter. Conclusion - Microdialysis is a safe technique providing more information on myocardial metabolism during and after bypass surgery than can be obtained from peripheral blood. The release of troponin-T in response to cardiac arrest can be distinguished in time from the local tissue response to probe implantation.

Original languageEnglish
Pages (from-to)308-312
Number of pages5
JournalScandinavian Cardiovascular Journal
Volume36
Issue number5
DOIs
Publication statusPublished - 2002

Keywords

  • Ischemia
  • Myocardium
  • Postoperative surveillance

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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