Myocardial perfusion during simultaneous antegrade/retrograde cardioplegia

Ganghong Tian, B. Xiang, G. Dai, J. Sun, J. Docherty, R. Mangat, T. A. Salerno, R. Deslauriers

Research output: Contribution to journalArticle

Abstract

Background: This study was to assess the effects of simultaneous antegrade/retrograde cardioplegia (SARC) on myocardial perfusion and energy metabolism in regions distal to a coronary occlusion. Methods: Isolated pig hearts with an occluded left anterior descending artery (LAD) were used as an experimental model. Magnetic resonance (MR) imaging in conjunction with contrast agent was used to determine whether SARC delivers blood cardioplegia to the myocardium supported by an occluded LAD. Fluorescence imaging was used to determine how blood cardioplegia delivered through the arterial route of SARC flows to the jeopardized myocardium. Localized 31P MR spectroscopy was used to determine whether SARC was able to sustain normal energy metabolism in the occluded region of the myocardium. Results: MR images showed that myocardium in the LAD region brightened during SARC with contrast agent given into either the aorta or coronary sinus. Fluorescence images showed illumination of the anterior ascending cardiac vein and its draining vessels in the LAD region during SARC when a fluorescent dye was given into the left circumflex coronary artery (LCX). 31P spectra showed that occlusion of the LAD during antegrade perfusion resulted in a significant decrease in phosphocreatine and an increase of inorganic phosphate. Use of SARC totally abolished the ischemic changes. Conclusion: Our results suggest that SARC delivers blood cardioplegia through both arterial and venous perfusion routes. It is through veno-venous anastomoses that antegradely delivered blood cardioplegia flows into the occluded region of myocardium. Finally, SARC is able to sustain normal myocardial energy metabolism in arrested heart.

Original languageEnglish (US)
Pages (from-to)50-57
Number of pages8
JournalCardiovascular Engineering
Volume8
Issue number1-2
StatePublished - 2003

Keywords

  • Fluorescence imaging
  • Magnetic resonance spectroscopy and imaging
  • Myocardial energy metabolism
  • Myocardial perfusion
  • Myocardial protection
  • Simultaneous cardioplegia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine (miscellaneous)

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  • Cite this

    Tian, G., Xiang, B., Dai, G., Sun, J., Docherty, J., Mangat, R., Salerno, T. A., & Deslauriers, R. (2003). Myocardial perfusion during simultaneous antegrade/retrograde cardioplegia. Cardiovascular Engineering, 8(1-2), 50-57.