Effects of sevoflurane versus propofol on cardiac mitochondrial functional activity and clinical parameters after heart surgery with cardiopulmonary bypass

Coronary artery bypass grafting surgery is now commonly used as a method for coronary insufficiency treatment. Myocardial dysfunction after coronary bypass graft surgery (CABG) is a well-known phenomenon called “ischemia/reperfusion injury”, which may significantly affect postoperative prognosis. There is increasing evidence that mitochondrial dysfunction plays a central role. We have investigated the effect of sevoflurane vs. propofol on cardiac mitochondrial functional activity and clinical parameters after heart surgery with cardiopulmonary bypass (CPB). In this perspective study was enrolled 72 patients (36 to sevoflurane and 36 to propofol group) scheduled for first-time elective CABG surgery with CPB. After ischemia/reperfusion mitochondrial respiratory rate decreased in both groups. Ischemia/reperfusion has caused the increasing damage of inner and outer mitochondrial membrane in both anesthetics groups. The damage of outer mitochondrial membrane caused a loss of cytochrome c, and the damage of inner mitochondrial membrane caused an increasing permeability to ions, without statistical differences between anesthetics groups. Ischemia/reperfusion induced a significantly lower heart muscle damage in sevoflurane group than propofol, as TnI level were significantly lower compared with propofol group. Hemodynamic stability, mechanical ventilation and stay of lenght in the intensive care unit during the early post-operative period in two anesthetic groups were not differ.