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J Thorac Cardiovasc Surg 1996;111:613-620
© 1996 Mosby, Inc.

CARDIOPULMONARY BYPASS, MYOCARDIAL MANAGEMENT, AND SUPPORT TECHNIQUES

TRANSIENT REPERFUSION WITH ACIDIC SOLUTION AFFECTS POSTISCHEMIC FUNCTIONAL RECOVERY: STUDIES IN THE ISOLATED WORKING RAT HEART

From the Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.

Received for publication Sept. 2, 1994 Accepted for publication June 1, 1995. Address for reprints: Fumio Yamamoto, MD, Department of Cardiovascular Surgery, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565, Japan.

Abstract

This isolated working rat heart study was designed to investigate the effect of duration of reperfusion and degree of acidity of the reperfusate on myocardial protection. The experimental time course was as follows: 20 minutes of perfusion with the heart working, 3 minutes of infusion with the St.Thomas' Hospital cardioplegic solution followed by global ischemia for 33 minutes at 37º C, and 20 minutes of Langendorff reperfusion followed by 20 minutes of working perfusion. During the initial 3 minutes of Langendorff reperfusion, the pH of the reperfusate was changed to 5.6, 6.8, and 7.5 by addition of sodium hydroxide into Krebs-Henseleit nonbicarbonate HEPES buffer. A respiratory acidic reperfusate was used for the initial 0.5, 1, 2, 3, 5, and 15 minutes during reperfusion. The results were as follows: (1) Reperfusion with a mildly acidic solution (i.e., pH 6.8) yielded better recovery than reperfusion with solutions having pH levels of 5.8 or 7.5. (2) Reperfusion for less than 3 minutes with a reperfusate having a pH level of 6.8 provided better recovery, although reperfusion for longer than 3 minutes exacerbated reperfusion injury. In conclusion, the effects of reperfusion with acidic solution were influenced by degree and duration with biphasic response characteristics. (J THORAC CARDIOVASC SURG 1996;111:613-20)

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