Recombinant factor VIIa affects anastomotic patency of vascular grafts in a rabbit model
| Autor: | Beiping Qiang, Zhilan Wang, Howard Leong-Poi, David A. Latter, James L. Mahoney, Harry Lapierre, Jerome M. Teitel, C. David Mazer, Zane S. Jackson, Tejinder Chhina, Bradley H. Strauss, Zuhair Alfardan, Gregory M. T. Hare |
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| Rok vydání: | 2011 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Activated clotting time Factor VIIa Anastomosis law.invention law Animals Vascular Patency Medicine Prothrombin time Dose-Response Relationship Drug medicine.diagnostic_test biology business.industry Anastomosis Surgical Graft Occlusion Vascular Thrombosis medicine.disease Recombinant Proteins Cardiac surgery Carotid Arteries Recombinant factor VIIa Anesthesia biology.protein Recombinant DNA Surgery Rabbits Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 142:418-423 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/j.jtcvs.2010.11.020 |
| Popis: | ObjectiveRecombinant factor VIIa can decrease postoperative bleeding after cardiac surgery. However, the potential for recombinant factor VIIa to cause early vascular graft occlusion at the site of new vascular anastomoses has not been fully explored. We hypothesized that recombinant factor VIIa would cause a dose-dependent reduction in vascular graft patency in rabbits.MethodsReversed end-to-end interpositional vein grafts were sutured into the carotid artery of heparinized rabbits, and then recombinant factor VIIa (300 μg/kg, 90 μg/kg, or 20 μg/kg intravenously) or placebo was administered (n = 16/group). Graft patency was assessed at 24 hours using a vascular ultrasound probe. Factor VII activity levels were measured using a prothrombin time-based assay. In different rabbits, the patency of venous end-to-side anastomoses and simple carotid arterial repairs was assessed (recombinant factor VIIa, 300 μg/kg vs placebo, n = 8/group). Data were analyzed using Fisher’s exact test, t tests, or analysis of variance.ResultsPhysiologic variables (activated clotting time, hemoglobin, pH, Pao2) and vessel diameter were not different between groups. Vein graft patency was reduced (93.8%, 81.2%, 13.8%, and 6.3%) as factor VII activity levels increased (1.8 ± 0.4, 4.4 ± 2.1, 11.8 ± 4.7, and 23.6 ± 16.9 U/mL, respectively) with increasing doses of recombinant factor VIIa administered (0, 20, 90, and 300 μg/kg, respectively, P |
| Databáze: | OpenAIRE |
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