Studies of controlled reperfusion after ischemia. VI. Metabolic and histochemical benefits of regional blood cardioplegic reperfusion with cardiopulmonary bypass

J. Vinten-Johansen, Eliot Rosenkranz, G. D. Buckberg

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

This study evaluates the capacity of regional substrate-enriched blood cardioplegia reperfusion (without bypass) to salvage cardiac muscle subjected to 40 minutes of regional ischemia. Results are compared with those obtained by normal blood reperfusion at either systemic or reduced perfusion pressure (i.e., simulating acute angioplasty or streptokinase thrombolysis). All studies were carried out in beating, working hearts when the conditions of reperfusion were not controlled. The results show that regional cardioplegic reperfusion without cardiopulmonary bypass reduces the incidence of reperfusion ventricular fibrillation (15% versus 55%, p < 0.05), increases recovery of subendocardial creatine phosphate (35.3 versus 14.0 μmol/gm, p < 0.05) and adenosine triphosphate (6.0 versus 3.1 μmol/gm, p < 0.05), reduces histochemical damage evaluated by triphenyltetrazolium chloride (0% versus 43% transmural nonstaining, p < 0.05), and improves myocardial contractile reserve capacity (91% versus 41%, p < 0.05). Normal blood reperfusion restored immediate systolic shortening in only 3 of 18 hearts (17%), and regional cardioplegic reperfusion without bypass produced early recovery of regional systolic shortening in only 10 of 16 hearts (63%, p > 0.05). Thus the value of controlling reperfusate composition without simultaneous control of reperfusion conditions is limited.

Original languageEnglish
Pages (from-to)535-542
Number of pages8
JournalJournal of Thoracic and Cardiovascular Surgery
Volume92
Issue number3 II
StatePublished - Jan 1 1986
Externally publishedYes

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Cardiopulmonary Bypass
Reperfusion
Ischemia
Induced Heart Arrest
Streptokinase
Ventricular Fibrillation
Angioplasty
Myocardium
Perfusion
Pressure
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

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title = "Studies of controlled reperfusion after ischemia. VI. Metabolic and histochemical benefits of regional blood cardioplegic reperfusion with cardiopulmonary bypass",
abstract = "This study evaluates the capacity of regional substrate-enriched blood cardioplegia reperfusion (without bypass) to salvage cardiac muscle subjected to 40 minutes of regional ischemia. Results are compared with those obtained by normal blood reperfusion at either systemic or reduced perfusion pressure (i.e., simulating acute angioplasty or streptokinase thrombolysis). All studies were carried out in beating, working hearts when the conditions of reperfusion were not controlled. The results show that regional cardioplegic reperfusion without cardiopulmonary bypass reduces the incidence of reperfusion ventricular fibrillation (15{\%} versus 55{\%}, p < 0.05), increases recovery of subendocardial creatine phosphate (35.3 versus 14.0 μmol/gm, p < 0.05) and adenosine triphosphate (6.0 versus 3.1 μmol/gm, p < 0.05), reduces histochemical damage evaluated by triphenyltetrazolium chloride (0{\%} versus 43{\%} transmural nonstaining, p < 0.05), and improves myocardial contractile reserve capacity (91{\%} versus 41{\%}, p < 0.05). Normal blood reperfusion restored immediate systolic shortening in only 3 of 18 hearts (17{\%}), and regional cardioplegic reperfusion without bypass produced early recovery of regional systolic shortening in only 10 of 16 hearts (63{\%}, p > 0.05). Thus the value of controlling reperfusate composition without simultaneous control of reperfusion conditions is limited.",
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