Document Detail


Role of amino acids and enhancement cardioplegia in routine myocardial protection. Experimental results.
MedLine Citation:
PMID:  8361193     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of this study was to determine the effects of the addition of amino acids to blood cardioplegic solution and the value of terminal cardioplegia enhancement techniques in routine myocardial protection. Forty-five open-chest adult dogs were instrumented with sonomicrometry crystals to measure left ventricular long axis, midequatorial short axis, and wall thickness. The aorta was clamped for 120 minutes of cardiopulmonary bypass. Animals were randomly separated into four myocardial protection groups: (1) blood cardioplegic solution with amino acids and no terminal cardioplegia (n = 12); (2) blood cardioplegic solution with amino acids and warm amino acid terminal cardioplegia (n = 11); (3) blood cardioplegic solution with amino acids and cold amino acid terminal cardioplegia (n = 12); and (4) blood cardioplegic solution plus cold terminal cardioplegia (no amino acids, n = 10). Data for preload recruitable stroke work were obtained by inflow occlusion before bypass (baseline) and at 30 and 60 minutes after reperfusion and analyzed for changes in x-intercept and slope. A significant rightward shift in x-intercept did not occur in any group. When cardiac function was expressed as a percentage of baseline preload recruitable stroke work slope, improved functional recovery was seen at both 30 and 60 minutes in groups 2 (88.6% and 91.8%), 3 (85.8% and 86.9%), and 4 (88.6% and 92.6%) compared with group 1 (77.3% and 79.2%, p < 0.05). No significant difference was found in the degree of functional recovery among groups 2, 3, and 4. These results suggest that for myocardial protection of 2 hours in nonischemic hearts, a terminal dose of blood cardioplegic solution before unclamping is beneficial, but this positive effect is independent of amino acid supplementation and temperature.
Authors:
G A Crooke; L J Harris; E A Grossi; F G Baumann; R Esposito; F C Spencer; S B Colvin; A C Galloway
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  106     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1993 Sep 
Date Detail:
Created Date:  1993-09-28     Completed Date:  1993-09-28     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  497-501     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, New York University Medical Center, NY 10016.
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MeSH Terms
Descriptor/Qualifier:
Amino Acids*
Animals
Aorta
Cardioplegic Solutions*
Constriction
Dogs
Heart / physiopathology
Heart Arrest, Induced / methods*
Temperature
Chemical
Reg. No./Substance:
0/Amino Acids; 0/Cardioplegic Solutions

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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