Document Detail


A biochemical and ultrastructural study on myocardial changes during aorto-coronary bypass surgery: St. Thomas Hospital cardioplegia versus intermittent aortic cross-clamping at 34 and 25 degrees C.
MedLine Citation:
PMID:  3484704     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The changes induced by continuous aortic cross-clamping in combination with multidose ice-cold St. Thomas Hospital cardioplegia (myocardial temperature below 16 degrees C), or intermittent aortic cross-clamping at 34 or 25 degrees C were evaluated in a randomized study on 72 patients undergoing extensive aorto-coronary bypass surgery. The cumulative release of heart-specific enzymes was very small and no marked ultrastructural changes in mitochondria of both the subepi- and the subendocardial layer of the left ventricular free wall occurred. No differences between the three operation techniques could be observed on the basis of the above-mentioned parameters. Myocardial ATP and glycogen contents were decreased in post-ischaemic tissue in both the normothermic and hypothermic intermittent aortic cross-clamp groups. This decrease was associated with a release of lactate and inorganic phosphate during the repetitive periods of reperfusion. No change in myocardial ATP and glycogen content could be observed in the cardioplegia-treated hearts. St. Thomas Hospital cardioplegia is obviously most effective in preventing changes in myocardial metabolism such as reduction of ATP and carbohydrate stores during the reversible phase of ischaemic insult.
Authors:
G J van der Vusse; F H van der Veen; W Flameng; W Coumans; M Borgers; G Willems; R Suy; R de Meyere; R S Reneman
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European surgical research. Europäische chirurgische Forschung. Recherches chirurgicales européennes     Volume:  18     ISSN:  0014-312X     ISO Abbreviation:  Eur Surg Res     Publication Date:  1986  
Date Detail:
Created Date:  1986-03-24     Completed Date:  1986-03-24     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0174752     Medline TA:  Eur Surg Res     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  1-11     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adenosine Triphosphate / metabolism
Adult
Aged
Aspartate Aminotransferases / blood
Constriction
Coronary Artery Bypass / methods*
Creatine Kinase / blood
Female
Glycogen / metabolism
Heart Arrest, Induced
Hemodynamics
Humans
Hypothermia, Induced
Isoenzymes
Lactates / blood
Male
Middle Aged
Mitochondria, Heart / ultrastructure*
Myocardium / metabolism*
Phosphates / blood
Phosphocreatine / metabolism
Potassium / blood
Random Allocation
Chemical
Reg. No./Substance:
0/Isoenzymes; 0/Lactates; 0/Phosphates; 56-65-5/Adenosine Triphosphate; 67-07-2/Phosphocreatine; 7440-09-7/Potassium; 9005-79-2/Glycogen; EC 2.6.1.1/Aspartate Aminotransferases; EC 2.7.3.2/Creatine Kinase

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


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