Journal of Cardiothoracic and Vascular Anesthesia
Volume 23, Issue 5 , Pages 594-599 , October 2009

Volatile Anesthetics Reduce Mortality in Cardiac Surgery

  • Elena Bignami, MD

      Affiliations

    • Department of Anesthesia and Intensive Care, Università Vita-Salute San Raffaele, Milan, Italy
    • ,
  • Giuseppe Biondi-Zoccai, MD

      Affiliations

    • Department of Interventional Cardiology, Division of Cardiology, Università di Torino, Turin, Italy
    • ,
  • Giovanni Landoni, MD

      Affiliations

    • Department of Anesthesia and Intensive Care, Università Vita-Salute San Raffaele, Milan, Italy
    • Corresponding Author InformationAddress reprint requests to Giovanni Landoni, MD, Department of Cardiothoracic Anesthesia and Intensive Care, Istituto Scientifico San Raffaele, Via Olgettina 60, Milan 20132, Italy
    • ,
  • Oliviero Fochi, MD

      Affiliations

    • Anesthesiology and Intensive Care Unit 1, Azienda Ospedaliera Niguarda Ca' Granda, Milano, Italia e Università degli Studi di Milano, Milan, Italy
    • ,
  • Valentina Testa, MD

      Affiliations

    • Department of Anesthesia and Intensive Care, Università Vita-Salute San Raffaele, Milan, Italy
    • ,
  • Imad Sheiban, MD

      Affiliations

    • Department of Interventional Cardiology, Division of Cardiology, Università di Torino, Turin, Italy
    • ,
  • Francesco Giunta, MD

      Affiliations

    • Department of Anesthesiology and Intensive Care, Università degli Studi di Pisa, Italia e Ospedale Santa Chiara, Pisa, Italy
    • ,
  • Alberto Zangrillo, MD

      Affiliations

    • Department of Anesthesia and Intensive Care, Università Vita-Salute San Raffaele, Milan, Italy

References 

  1. Landoni G, Fochi O, Tritapepe L, et al. Cardiac protection by volatile anesthetics (A review). Minerva Anestesiol. 2008;74:1–5
  2. Landoni G, Biondi-Zoccai GG, Zangrillo A, et al. Desflurane and sevoflurane in cardiac surgery: A meta-analysis of randomized clinical trials. J Cardiothorac Vasc Anesth. 2007;21:502–511
  3. Symons JA, Myles PS. Myocardial protection with volatile anaesthetic agents during coronary artery bypass surgery: A meta-analysis. Br J Anaesth. 2006;97:127–136
  4. Yu CH, Beattie WS. The effects of volatile anesthetics on cardiac ischemic complications and mortality in CABG: A meta-analysis. Can J Anaesth. 2006;53:906–918
  5. Tritapepe L, Landoni G, Guarracino F, et al. Cardiac protection by volatile anaesthetics: A multicentre randomized controlled study in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass. Eur J Anaesthesiol. 2007;24:323–331
  6. Guarracino F, Landoni G, Tritapepe L, et al. Myocardial damage prevented by volatile anesthetics: A multicenter randomized controlled study. J Cardiothorac Vasc Anesth. 2006;20:477–483
  7. Jakobsen CJ, Berg H, Hindsholm KB, et al. The influence of propofol versus sevoflurane anesthesia on outcome in 10,535 cardiac surgical procedures. J Cardiothorac Vasc Anesth. 2007;21:664–671
  8. Cromheecke S, Pepermans V, Hendrickx E, et al. Cardioprotective properties of sevoflurane in patients undergoing aortic valve replacement with cardiopulmonary bypass. Anesth Analg. 2006;103:289–296
  9. Landoni G, Calabro MG, Marchetti C, et al. Desflurane versus propofol in patients undergoing mitral valve surgery. J Cardiothorac Vasc Anesth. 2007;21:672–677
  10. Landoni G, Zangrillo A, Fochi O, et al. Cardiac protection with volatile anesthetics in stenting procedures. J Cardiothorac Vasc Anesth. 2008;22:543–547
  11. Fochi O, Bignami E, Landoni G, et al. Cardiac protection by volatile anesthetics in noncardiac surgery (A meta-analysis). Minerva Anestesiol. 2007;73:26;(abstr)
  12. De Hert SG, Longrois D, Yang H, et al. Does the use of a volatile anesthetic regimen attenuate the incidence of cardiac events after vascular surgery?. Acta Anaesthesiol Belg. 2008;59:19–25
  13. Fleisher LA, Beckman JA, Brown KA, et al. ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: Executive Summary (A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery)). J Am Coll Cardiol. 2007;50:1707–1732
  14. Landoni G, Fochi O, Zangrillo A. Cardioprotection by volatile anesthetics in noncardiac surgery? (No, not yet at least). J Am Coll Cardiol. 2008;51:1321
  15. Seccareccia F, Perucci CA, D'Errigo P, et al. The Italian CABG Outcome Study: Short-term outcomes in patients with coronary artery bypass graft surgery. Eur J Cardiothorac Surg. 2006;29:56–62
  16. Belhomme D, Peynet J, Louzy M, et al. Evidence for preconditioning by isoflurane in coronary artery bypass graft surgery. Circulation. 1999;100:340–344
  17. Ndoko SK, Tual L, Ait Mamar B, et al. Isoflurane, 0.5 minimum alveolar concentration administered through the precardiopulmonary bypass period, reduces postoperative dobutamine requirements of cardiac surgery patients: a randomized study. J Cardiothorac Vasc Anesth. 2007;21:683–689
  18. Lee MC, Chen CH, Kuo MC, et al. Isoflurane preconditioning-induced cardioprotection in patients undergoing coronary artery bypass grafting. Eur J Anaesthesiol. 2006;23:841–847
  19. De Hert SG, Van der Linden PJ, Cromheecke S, et al. Cardioprotective properties of sevoflurane in patients undergoing coronary surgery with cardiopulmonary bypass are related to the modalities of its administration. Anesthesiology. 2004;101:299–310
  20. Warltier DC, al-Wathiqui MH, Kampine JP, et al. Recovery of contractile function of stunned myocardium in chronically instrumented dogs is enhanced by halothane or isoflurane. Anesthesiology. 1988;69:552–565
  21. Cason BA, Gamperl AK, Slocum RE, et al. Anesthetic-induced preconditioning: Previous administration of isoflurane decreases myocardial infarct size in rabbits. Anesthesiology. 1997;87:1182–1190
  22. Chiari P, Bouvet F, Piriou V. Anaesthetic-induced myocardial preconditioning: Fundamental basis and clinical implications. Ann Fr Anesth Reanim. 2005;24:383–396
  23. Varadarajan SG, An J, Novalija E, et al. Sevoflurane before or after ischemia improves contractile and metabolic function while reducing myoplasmic Ca(2+) loading in intact hearts. Anesthesiology. 2002;96:125–133
  24. Ross S, Foex P. Protective effects of anaesthetics in reversible and irreversible ischaemia-reperfusion injury. Br J Anaesth. 1999;82:622–632
  25. Toller WG, Kersten JR, Pagel PS, et al. Sevoflurane reduces myocardial infarct size and decreases the time threshold for ischemic preconditioning in dogs. Anesthesiology. 1999;91:1437–1446
  26. Preckel B, Schlack W, Comfere T, et al. Effects of enflurane, isoflurane, sevoflurane and desflurane on reperfusion injury after regional myocardial ischaemia in the rabbit heart in vivo. Br J Anaesth. 1998;81:905–912
  27. Tuman KJ, McCarthy RJ, Spiess BD, et al. Does choice of anesthetic agent significantly affect outcome after coronary artery surgery?. Anesthesiology. 1989;70:189–198
  28. De Hert SG, ten Broecke PW, Mertens E, et al. Sevoflurane but not propofol preserves myocardial function in coronary surgery patients. Anesthesiology. 2002;97:42–49
  29. Peterson ED, Coombs LP, DeLong ER, et al. Procedural volume as a marker of quality for CABG surgery. JAMA. 2004;291:195–201

 G.L. acknowledges receiving modest honorariums from Abbott (sevoflurane), Baxter (desflurane and isoflurane), and Minrad (desflurane, isoflurane, and sevoflurane).

PII: S1053-0770(09)00025-1

doi: 10.1053/j.jvca.2009.01.022

Journal of Cardiothoracic and Vascular Anesthesia
Volume 23, Issue 5 , Pages 594-599 , October 2009

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