| Fetal right ventricular myocardial function is better preserved by fibrillatory arrest during fetal cardiac bypass. | |
| | |
MedLine Citation:
|
PMID: 20868837 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Protection and preservation of fetal myocardial function are important for successful fetal intracardiac repair. Our objective was to determine fetal biventricular cardiac performance after two cardiac-arrest techniques. METHODS: Three groups of midterm ovine fetuses underwent 90-minute bypass. A control group (no arrest shams, n = 3), and two groups that included 20 minutes of arrest, using fibrillatory (n = 3) or blood cardioplegia (n = 3), were compared. Blood cardioplegia consisted of 4:1 cold blood to crystalloid solution induction every 10 minutes, followed by a warm shot terminal dose before clamp removal. Myocardial function variables from biventricular intracardiac pressure catheters, and 3-axes cardiac sonomicrometry, fetal hemodynamics, and arterial blood gases were continuously recorded. Fetal myocardium was collected for troponin-I analysis at 90 minutes. Statistical analysis was by two-way analysis of variance for repeated measures. RESULTS: Compared with sham, right ventricular myocardial contractility was reduced with plegia but not fibrillation at 90 minutes after arrest: dP/dt max (511 ± 347 vs 1208 ± 239, p < 0.01) and preload-recruitable stroke work (7.2 ± 8.5 vs 32.3 ± 14.6, p < 0.01). Right ventricular end diastolic pressure-volume relationship (ventricular stiffness) worsened by 90 minutes for plegia vs fibrillation (0.84 ± 0.18 vs 0.25 ± 0.16, p < 0.05). There were no differences in left ventricle performance between groups. Fetal heart rate increased in shams by 30 minutes after arrest compared with both arrest groups (p < 0.05). Right ventricular troponin-I degradation increased with plegia, but not fibrillation, compared with sham (p < 0.05). CONCLUSIONS: In vivo, fetal right ventricular contractile function deteriorates with a common blood-plegia regimen. Fibrillatory arrest better preserves right ventricular function, the dominant ventricle in fetal life, for short arrest periods. |
| | |
Authors:
|
Orlando Petrucci; R Scott Baker; Christopher T Lam; Casey A Reed; Jodie Y Duffy; Pirooz Eghtesady |
Related Documents
:
|
9657167 - Morbidity and mortality associated with anesthetic management in small animal veterinar... 21964497 - Prospectively ecg-triggered high-pitch spiral acquisition for cardiac ct angiography in... 16322737 - Duration of cardiopulmonary resuscitation before extracorporeal rescue: how long is not... 15680537 - Successful resuscitation after sudden death in a one year old infant who sustained a bl... 21240507 - Coronary sinus ostium: the key structure in the heart's anatomy from the electrophysiol... 7432607 - Spontaneous migration of a central venous catheter and its repositioning: technical note. |
Publication Detail:
|
Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: The Annals of thoracic surgery Volume: 90 ISSN: 1552-6259 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2010 Oct |
Date Detail:
|
Created Date: 2010-09-27 Completed Date: 2010-10-21 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: Netherlands |
Other Details:
|
Languages: eng Pagination: 1324-31 Citation Subset: AIM; IM |
Copyright Information:
|
Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. |
Affiliation:
|
Division of Cardiothoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Animals Cardioplegic Solutions Cardiopulmonary Bypass / methods* Female Fetus / surgery* Heart Arrest, Induced / methods* Heart Defects, Congenital / surgery* Hemodynamics Pregnancy Recovery of Function Sheep Ventricular Fibrillation / metabolism* Ventricular Function, Right* |
| Grant Support | |
ID/Acronym/Agency:
|
1R21-HL093683/HL/NHLBI NIH HHS; 3R21HL093683-01A1S1/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Cardioplegic Solutions |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Early surgical correction of atrioventricular valvular regurgitation in single-ventricle patients.
Next Document: Early monitoring of the viability of the buried intrathoracic omental flap: a feasibility study.