ASSESSING MYOCARDIAL PERFUSION WITH ALBUNEX DURING CORONARY-ARTERY BYPASS-SURGERY - TECHNICAL CONSIDERATIONS AND SAFETY OF AORTIC ROOT INJECTIONS

Objective: To test the safety and report on limiting technical conside rations, including optimal dosing of Albunex (Molecular Biosystems, In c, Mallinckrodt Medical, St. Louis, MO) for myocardial opacification a fter intra-aortic root injections during cardiac surgery. Design: This was a prospective randomized study with a control group who did not r eceive Albunex and a group who received intra-aortic root injections o f Albunex. Setting: Multicenter (two) independent university hospitals . Participants: 32 patients scheduled for elective coronary artery byp ass surgery were evaluated after individual informed consent was obtai ned. Interventions: 2 to 8 mt of Albunex were injected before and afte r coronary revascularization. Measurements and Main Results: Quality o f enhancement in each of four regions of the left ventricle was assess ed from a short-axis mid-papillary ultrasound image by three experienc ed observers blinded to dose. Electrocardiogram (EGG), creatine phosph okinase (CPK) (MB fraction), and hemodynamics were evaluated at baseli ne and throughout the study period for up to 72 hours. No differences were noted between groups with respect to preoperative and postoperati ve CPK enzymes (CPK-MB fraction), ECG changes, hemodynamics, requireme nts for separation from CPB, need for postoperative inotropes, time to extubation, and time to discharge from the intensive care unit. The a verage total dose of Albunex injected was 19 mL +/- 4 (0.25 mL/kg). A single dose of 4.2 +/- 1.2 mt (0.05 mL/kg) appeared to offer optimal e nhancement of contrast effect for myocardial perfusion assessment. Con clusion: Albunex is safe and easy to use for myocardial opacification when administered via an antegrade cardioplegia catheter into the aort ic root during CPB. Copyright (C) 1996 by W.B. Saunders Company