Document Detail

The temperature dependence of cardioplegic distribution in the canine heart.
MedLine Citation:
PMID:  10969689     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Cold cardioplegic arrest can produce cooling contracture and suboptimal myocardial protection. This study examines whether cooling contracture is associated with maldistribution of cardioplegic solution, particularly subendocardial hypoperfusion, which may impair recovery. METHODS: Canine hearts were arrested by antegrade cold and warm blood cardioplegia in random order. Cardioplegic distribution was measured using radiolabeled microspheres before and just after induction of each period of arrest. RESULTS: With cold cardioplegia, perfusion of left ventricular subepicardial and midwall regions decreased. Subendocardial to subepicardial perfusion ratios increased significantly in the left ventricle as a whole, the anterior and posterior regions of the left ventricular free wall, and the interventricular septum. With warm arrest, transmural flow distribution was not significantly altered from preceding prearrest values. At constant coronary flow, coronary perfusion pressure was initially similar after induction of arrest at both temperatures, but it rose subsequently during warm cardioplegia. CONCLUSIONS: The data suggest that during normothermic arrest, vasomotor tone regulates cardioplegic distribution, and hyperkalemic vasoconstriction is of slow onset. In the absence of beating and with vasomotion inhibited by hypothermia, cardioplegic distribution during cold arrest appears to be primarily dependent on vascular anatomy. There was no evidence of subendocardial underperfusion during cooling contracture.
D F Torchiana; A J Vine; J S Titus; C Hahn; K O Shebani; G A Geffin; W M Daggett
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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 Annals of thoracic surgery     Volume:  70     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2000 Aug 
Date Detail:
Created Date:  2000-09-27     Completed Date:  2000-09-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  614-20     Citation Subset:  AIM; IM    
Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston 02114, USA.
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MeSH Terms
Cardioplegic Solutions / pharmacokinetics*
Coronary Vessels / physiology
Evaluation Studies as Topic
Heart / physiology*
Heart Arrest, Induced*
Random Allocation
Regional Blood Flow
Vascular Resistance
Grant Support
Reg. No./Substance:
0/Cardioplegic Solutions

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

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