Abstract
Background.: Retrograde normothermic blood cardioplegia has been shown to provide myocardial protection during certain bypass procedures. However, a number of animal studies have shown less than optimal myocardial protection with this technique. Methods.: Isolated, beating porcine hearts were perfused antegradely (aortic root pressure = 75 to 95 mm Hg) for 30 minutes. Arrest was induced and maintained for 60 minutes with high K+ blood cardioplegia delivered either antegradely (n = 8) or retrogradely (n = 8) (coronary sinus pressure = 35 to 55 mm Hg). Perfusate was switched to normokalemic blood for recovery of sinus rhythm (30 minutes). Intracellular pH, creatine phosphate, inorganic phosphate, and adenosine triphosphate were monitored continuously and noninvasively with phosphorus 31 magnetic resonance spectroscopy throughout the experiment, and functional variables (rate-pressure product and the positive and negative first derivatives of left ventricular pressure) were assessed concurrently. Results.: Antegrade cardioplegia maintained high-energy metabolites, intracellular pH, and myocardial function. Retrograde normothermic blood cardioplegia resulted in an increase in inorganic phosphate (197% ± 15% of control) and a decrease in creatine phosphate (51% ± 6% of control). There was no significant difference in myocardial function between the two groups (p > 0.05). The magnetic resonance spectroscopy data indicate ischemia occurred within 2 minutes of the initiation of retrograde perfusion. Conclusions.: This study suggests that retrograte normothermic blood cardioplegia causes a transition of the myocardium to ischemic metabolism in the normal porcine heart.
| Original language | English |
|---|---|
| Pages (from-to) | 1203-1209 |
| Number of pages | 7 |
| Journal | The Annals of Thoracic Surgery |
| Volume | 60 |
| Issue number | 5 |
| DOIs | |
| State | Published - Jan 1 1995 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Pulmonary and Respiratory Medicine
- Surgery
Cite this
Antegrade and retrograde continuous warm blood cardioplegia : A 31P magnetic resonance study. / Hoffenberg, Edward F.; Ye, Jian; Sun, Jiankang; Ghomeshi, Hooman R.; Salerno, Tomas; Deslauriers, Roxanne.
In: The Annals of Thoracic Surgery, Vol. 60, No. 5, 01.01.1995, p. 1203-1209.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Antegrade and retrograde continuous warm blood cardioplegia
T2 - A 31P magnetic resonance study
AU - Hoffenberg, Edward F.
AU - Ye, Jian
AU - Sun, Jiankang
AU - Ghomeshi, Hooman R.
AU - Salerno, Tomas
AU - Deslauriers, Roxanne
PY - 1995/1/1
Y1 - 1995/1/1
N2 - Background.: Retrograde normothermic blood cardioplegia has been shown to provide myocardial protection during certain bypass procedures. However, a number of animal studies have shown less than optimal myocardial protection with this technique. Methods.: Isolated, beating porcine hearts were perfused antegradely (aortic root pressure = 75 to 95 mm Hg) for 30 minutes. Arrest was induced and maintained for 60 minutes with high K+ blood cardioplegia delivered either antegradely (n = 8) or retrogradely (n = 8) (coronary sinus pressure = 35 to 55 mm Hg). Perfusate was switched to normokalemic blood for recovery of sinus rhythm (30 minutes). Intracellular pH, creatine phosphate, inorganic phosphate, and adenosine triphosphate were monitored continuously and noninvasively with phosphorus 31 magnetic resonance spectroscopy throughout the experiment, and functional variables (rate-pressure product and the positive and negative first derivatives of left ventricular pressure) were assessed concurrently. Results.: Antegrade cardioplegia maintained high-energy metabolites, intracellular pH, and myocardial function. Retrograde normothermic blood cardioplegia resulted in an increase in inorganic phosphate (197% ± 15% of control) and a decrease in creatine phosphate (51% ± 6% of control). There was no significant difference in myocardial function between the two groups (p > 0.05). The magnetic resonance spectroscopy data indicate ischemia occurred within 2 minutes of the initiation of retrograde perfusion. Conclusions.: This study suggests that retrograte normothermic blood cardioplegia causes a transition of the myocardium to ischemic metabolism in the normal porcine heart.
AB - Background.: Retrograde normothermic blood cardioplegia has been shown to provide myocardial protection during certain bypass procedures. However, a number of animal studies have shown less than optimal myocardial protection with this technique. Methods.: Isolated, beating porcine hearts were perfused antegradely (aortic root pressure = 75 to 95 mm Hg) for 30 minutes. Arrest was induced and maintained for 60 minutes with high K+ blood cardioplegia delivered either antegradely (n = 8) or retrogradely (n = 8) (coronary sinus pressure = 35 to 55 mm Hg). Perfusate was switched to normokalemic blood for recovery of sinus rhythm (30 minutes). Intracellular pH, creatine phosphate, inorganic phosphate, and adenosine triphosphate were monitored continuously and noninvasively with phosphorus 31 magnetic resonance spectroscopy throughout the experiment, and functional variables (rate-pressure product and the positive and negative first derivatives of left ventricular pressure) were assessed concurrently. Results.: Antegrade cardioplegia maintained high-energy metabolites, intracellular pH, and myocardial function. Retrograde normothermic blood cardioplegia resulted in an increase in inorganic phosphate (197% ± 15% of control) and a decrease in creatine phosphate (51% ± 6% of control). There was no significant difference in myocardial function between the two groups (p > 0.05). The magnetic resonance spectroscopy data indicate ischemia occurred within 2 minutes of the initiation of retrograde perfusion. Conclusions.: This study suggests that retrograte normothermic blood cardioplegia causes a transition of the myocardium to ischemic metabolism in the normal porcine heart.
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U2 - 10.1016/0003-4975(95)00547-X
DO - 10.1016/0003-4975(95)00547-X
M3 - Article
VL - 60
SP - 1203
EP - 1209
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
SN - 0003-4975
IS - 5
ER -