Changes in serum trace element levels during cardiopulmonary bypass and its effects on myocardial damage

Abstract

Aim: Inflammatory response to cardiopulmonary bypass (CPB) continues to be a significant problem today. Material and method: A total of 40 patients who had undergone arterial bypass under elective conditions were included in the study. Of all patients, 32 were male (80%) and 8 were female (20%). Mean age was 62.50 +/- 1.95 (range 45, min 36 - max 81). 3 6 patients (90%) had triple vessel disease and 4 patients had (10%) double vessel disease. 14 patients (35%) had previously undergone angioplasty or stent operations. Two patients (5%) had Canada Class I, 25 patients had (62.5%) Class II, 12 patients had (30%) Class III and 1 patient had (2.5%) Class IV functional capacity. Results: The number of bypass grafts applied on the patients was 3.27 +/- 0.12 in average. The mean cardiopulmonary bypass duration was 113 3.93 min. The mean aortic cross-clamp (ACC) duration was 75.4 +/- 3.99 min. Operative mortality was 2.5%. Serum copper (Cu) values, which had been measured as 0.83 +/- 0.01 mu g/ml in average preoperatively, increased throughout the operation and reached its peak value (1.36 +/- 0.02 mu g/ml) at the end of CPB. Despite the drastic fall in serum copper level in the first 24 hours, it reached its normal blood value on the fifth day following the operation. Serum zinc (Zn) value, which had been 1.06 - 0.02 mu g/ml preoperatively, showed a dramatic fall in the first 30 min of the CPB and reached 0.65 +/- 0.01 mu g/ml (p < 0.001). Serum zinc level gradually decreased throughout the CPB and reached its lowest level at the end of the operation. It reached its normal blood value on the fifth day following the operation. Serum CPKMb mass value gradually increased throughout the CPB and reached its peak value at the end of the operation. It fell to its normal blood value on the third day following the operation. Discussion: Trace element changes occurring during the cardiopulmonary bypass have been found to be closely related with myocardial ischemia.