ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
The Effects of Extracorporeal Circulation on Circulating Endothelin-1 and Atrial Natriuretic Peptide Levels During Valvular Replacement and Coronary Artery Bypass Greft Surgery
İbrahim YEKELER, Mustafa ABANOZ, Fatih AKÇAY, Erhan VAROĞLU, Erdal EGE, Azman ATEŞ, Hikmet KOÇAK
Atatürk Üniversitesi Tıp Fakültesi Göğüs Kalp Damar Cerrahisi Anabilim Dalı, Biyokimya, Nükleer Tıp Anabilim Dalları, Erzurum

This study was carried out in order to investigate the effects of extracorporeal circulation on plasma ET-1 and ANP concentrations of patients with mitral valve disease (group I, n=15) and coronary artery disease (group II, n=15). Eight blood samples were taken from internal juguler vein: 1) before induction, 2) just after induction, 3) before 5 minutes of aortic crossclam-ping, 4) after 5. minutes of aortic cross-clamping, 5) 20 minutes after aortic crossclamping, 6) 4 hours after removing aortic crossclamp, 7) 24 and 8) 72 hours after extracorporeal circulation. There was no significant difference between the preoperative ET-1 levels of baseline values of the group I patients and controls. ET-1 began to increase after induction and during partial extracorporeal circulation. After that, ET-1 reached the maximum level at 20th minute of crossclamping and decreased postoperatively. In group II, baseline levels of ET-1 were higher than those of the controls. Imediately afer induction and partial extracorporeal circulation, ET-1 levels began to rise and reached maximum value 5 minutes after aortic crossclamping. Then ET-1 began minutes after aortic crossclamping. Then ET-1 began to decrease at the 20th minute after aortic cross-clamping, and continued up to 72 hours postoperatively. In groups I and II, preoperative p-ANP levels were found to be significantly higher than those of the controls, p-ANP levels decreased significanly after induction and increased after partial extracorporeal circulation and 5 minutes before cross-clamping, these increase also continued at 5th minute afer crosclamping and reached the maximum level at the 20th minute after crossclamping, p-ANP levels decreased postoperatively beginning wih 4 hours after removing aortic crossclamp.

We concluded that, the changes in courses of ET-1 and p-ANP level may give an information for evaluating the patients, undergonig coronary bypass greft surgery and mitral valve replacement surgery, after follow up.

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