Document Detail

Prolonged neonatal myocardial preservation with a highly buffered low-calcium solution.
MedLine Citation:
PMID:  7934115     Owner:  NLM     Status:  MEDLINE    
Optimal methods of myocardial preservation remain controversial in the neonate. This study compared prolonged hypothermic storage of neonatal hearts with modified University of Wisconsin solution (group I) with a solution formulated to promote anaerobic glycolysis by providing proton buffering with histidine (100 mmol/L) and exogenous glucose and insulin (group II). Hearts from piglets aged 3 to 5 days were given a single dose of either solution (n = 6 each), subjected to 20 hours of global ischemia at 4 degrees C, and reperfused with an erythrocyte-enhanced perfusate in an isovolumic Langendorff preparation. After 1 hour of reperfusion, in comparison with hearts preserved with University of Wisconsin solution, those in group II demonstrated (mean +/- standard error of the mean) greater left ventricular developed pressure (101 +/- 7 versus 62 +/- 9 mm Hg, p < 0.01) and the first derivative of left ventricular pressure (816 +/- 23 versus 614 +/- 69 mm Hg.sec-1, p < 0.05). Diastolic indices were reduced to a similar degree in the two groups. Myocardial oxygen consumption was significantly greater (38.8 +/- 2.4 versus 11.8 +/- 2.4 microliters oxygen.min.g-1, p < 0.01) in group II hearts. Group I hearts vasoconstricted (6% increase in coronary vascular resistance) in response to an intracoronary infusion of acetylcholine (20 nmol.min-1); in contrast, acetylcholine produced coronary dilation in group II hearts (5% decrease in coronary resistance, p < 0.02) that was similar to that observed in nonischemic control hearts. These results demonstrate enhanced preservation of myocardial contractility, oxidative metabolism, and vascular function in neonatal hearts provided by a solution designed to buffer protons and promote anaerobic glycolysis during ischemia.
F X McGowan; H Cao-Danh; K Takeuchi; P J Davis; P J del Nido
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  108     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1994 Oct 
Date Detail:
Created Date:  1994-11-02     Completed Date:  1994-11-02     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  772-9     Citation Subset:  AIM; IM    
Department of Anesthesiology/CCM, University of Pittsburgh School of Medicine, Pa.
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MeSH Terms
Animals, Newborn
Cardioplegic Solutions*
Coronary Vessels / physiology
Organ Culture Techniques
Organ Preservation / methods*
Vascular Resistance
Grant Support
Reg. No./Substance:
0/Cardioplegic Solutions

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