Effect of Coronary Bypass and Cardiac Valve Surgery on Systemic Endothelial Function

The purpose of this study was to assess the effect of cardiopulmonary bypass (CPB) on systemic endothelial function using serial perioperative brachial artery flow-mediated dilation (FMD) in cardiac surgery patients. The hypothesis was that transient endothelial dysfunction develops acutely after surgery and resolves in a matter of days, paralleling the recognized time frame of increases and decreases in acute phase reactants after CPB. ••• From January to April 1999, 17 consecutive eligible patients admitted for elective cardiac surgery were prospectively enrolled in the study. Entry criteria were age .18 years and subjects scheduled for cardiac procedure necessitating CPB. Exclusion criteria were technically uninterpretable brachial artery ultrasound, nitrate administration in the 24 hours preceding first testing, surgical complication (myocardial infarction, sepsis, shock, second thoracotomy, and death) before the last brachial artery testing and refusal or incapacity to give informed consent. The study was approved by