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The Journal of Thoracic and Cardiovascular Surgery, Vol 104, 159-164, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
KH Teoh, DA Mickle, RD Weisel, RK Li, LC Tumiati, JG Coles and WG Williams
Since the chronically cyanotic myocardium appears to be more susceptible to
reperfusion injury after cardiac operations than the noncyanotic
myocardium, we studied the association between the preoperative arterial
oxygen tension and the myocardial superoxide dismutase, catalase, and
glutathione peroxidase activities. Fourteen patients with tetralogy of
Fallot scheduled for elective operations had baseline arterial blood gas
measurements done before operation. During the operation right ventricular
biopsy specimens were taken for enzyme analysis immediately before cold
blood cardioplegic arrest and 20 minutes after crossclamp removal. The
tissue antioxidant enzyme activities of the patients with tetralogy of
Fallot were compared with the myocardial results in 15 adults with stable
angina pectoris having elective aorta-coronary artery bypass graft
operations. Myocardial tissues removed from two patients with hypertrophic
obstructive cardiomyopathy who had corrective operations were analyzed for
antioxidant activities. There were no changes in myocardial antioxidant
enzyme activities during the operation in the patients with tetralogy of
Fallot and coronary artery bypass graft. The myocardial superoxide
dismutase, catalase, and glutathione peroxidase activities correlated
(0.82, 0.68, and 0.89, respectively) significantly (p values were less than
0.01, 0.05, and 0.01, respectively) with the preoperative arterial oxygen
tensions in the patients with tetralogy of Fallot. The myocardial
glutathione peroxidase activities were at least four times higher in the
myocardium of patients with coronary artery bypass graft and hypertrophic
obstructive cardiomyopathy than in that of those with tetralogy of Fallot.
This study provides putative evidence that the myocardium of patients with
tetralogy of Fallot is a risk of oxygen- derived free radical injury during
and immediately after corrective cardiovascular operations.
ARTICLES
Effect of oxygen tension and cardiovascular operations on the myocardial antioxidant enzyme activities in patients with tetralogy of Fallot and aorta-coronary bypass
Centre of Cardiovascular Research, Toronto Hospital, Hospital for Sick Children, University of Toronto, Ontario, Canada.
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