Beneficial effects of potassium cardioplegia during intermittent aortic cross-clamping and reperfusion

作者: Ruel N. Wright , Sidney Levitsky , Charles Holland , Harold Feinberg

DOI: 10.1016/0022-4804(78)90175-0

关键词: CreatinePerfusionBalloonIschemiaContractilityAnesthesiaCardiologyAir embolismCardiopulmonary bypassInternal medicinePotassiumMedicineSurgery

摘要: Abstract Aortic cross-clamping is an essential adjunct to a variety of cardiac surgical procedures requiring quiet flaccid heart and avoidance systemic air embolism. The consequences excluding the from perfusion, oxygen, substrate are time dependent lead ultimately irreversible damage myocardium. goal complete preservation myocardial function metabolism during ischemia has not been realized even with best clinically applicable techniques. present study was designed evaluate effects sequential aortic interrupted by reperfusion similar that used in clinical practice. advantages induced arrest potassium chloride solution at onset were assessed second group animals. A total 27 mongrel dogs supported normothermic cardiopulmonary bypass subjected four cross-clamp periods 5-min reper-fusion periods. included evaluation left ventricular performance using isovolumic balloon technique assessment “stop-freeze” biopsies biochemical assay for ATP, ADP, AMP, creatine phosphate. data demonstrate repeated induction ischemic results profound depletion adenine nucleo-tides severe depression contractility. Using potassium-induced arrest, normal contractile preserved along conservation nucleo-tides, suggesting normothermia, can be achieved.

参考文章(31)
Randall B. Griepp, Edward B. Stinson, Norman E. Shumway, Profound local hypothermia for myocardial protection during open-heart surgery. The Journal of Thoracic and Cardiovascular Surgery. ,vol. 66, pp. 731- 741 ,(1973) , 10.1016/S0022-5223(19)40565-5
Charles E. Ganote, Robert B. Jennings, Daniel A. Whalen, Donald G. Hamilton, Effect of a Transient Period of Ischemia on Myocardial Cells: I. Effects on Cell Volume Regulation American Journal of Pathology. ,vol. 74, pp. 381- 397 ,(1974)
Anthony C. Shen, Robert B. Jennings, Kinetics of calcium accumulation in acute myocardial ischemic injury. American Journal of Pathology. ,vol. 67, pp. 441- 452 ,(1972)
Charles E. Ganote, Robert A. Kloner, Robert B. Jennings, Daniel A. Whalen, Effect of a transient period of ischemia on myocardial cells. II. Fine structure during the first few minutes of reflow. American Journal of Pathology. ,vol. 74, pp. 399- 422 ,(1974)
DON R. MILLER, PETER RASMUSSEN, BERNARD KLIONSKY, REVERSIBILITY OF MORPHOLOGIC CHANGES FOLLOWING ELECTIVE CARDIAC ARREST. Annals of Surgery. ,vol. 159, pp. 208- 218 ,(1964) , 10.1097/00000658-196402000-00005
Sidney Levitsky, Robert E. Sloane, Edward M. Mullin, Charles L. McIntosh, Andrew G. Morrow, Normothermic Myocardial Anoxia: Effects on the Canine Heart with Left Ventricular Outflow Obstruction The Annals of Thoracic Surgery. ,vol. 11, pp. 229- 237 ,(1971) , 10.1016/S0003-4975(10)65443-4
Charles E. Holland, Harold Feinberg, Sidney Levitsky, Zenonas Buinevicius, Ruel N. Wright, Serial myocardial biopsies using an improved microfluorometric assay Journal of Surgical Research. ,vol. 25, pp. 342- 348 ,(1978) , 10.1016/0022-4804(78)90129-4
Frederick J. Merchant, Harold Feinberg, Sidney Levitsky, Sequential analysis of altered myocardial metabolism and contractility induced by normothermic arrest and reperfusion Journal of Surgical Research. ,vol. 16, pp. 153- 161 ,(1974) , 10.1016/0022-4804(74)90023-7
L. MAXIMILIAN BUJA, SIDNEY LEVITSKY, VICTOR J. FERRANS, SHERMAN G. SOUTHER, WILLIAM C. ROBERTS, ANDREW G. MORROW, Acute and chronic effects of normothermic anoxia on canine hearts. Light and electron microscopic evaluation. Circulation. ,vol. 43, ,(1971) , 10.1161/01.CIR.43.5S1.I-44
D.G. Melrose, B. Dreyer, H.H. Bentall, J.B.E. Baker, Elective cardiac arrest. The Lancet. ,vol. 266, pp. 21- 23 ,(1955) , 10.1016/S0140-6736(55)93381-X