HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ciardullo, R. C. Articles by Gott, V. L. Search for Related Content PubMed PubMed Citation Articles by Ciardullo, R. C. Articles by Gott, V. L.

The Journal of Thoracic and Cardiovascular Surgery, Vol 75, 193-205, Copyright © 1978 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Comparison of regional myocardial blood flow and metabolism distal to a critical coronary stenosis in the fibrillating heart during alternate periods of pulsatile and nonpulsatile perfusion

RC Ciardullo, HV Schaff, JT Flaherty, JS Donahoo and VL Gott

The effect of pulsatile cardiopulmonary bypass on intramyocardial gas tensions and regional myocardial blood flow was studied in 10 mongrel dogs. Following application of a critical stenosis to the circumflex coronary artery (CIRC), animals were placed on total bypass with vented, fibrillating hearts. During three 45 minute periods of perfusion, animals alternately received pulsatile or linear flow with perfusion pressure carefully maintained at 80 mm. Hg. In myocardium supplied by the stenosed CIRC, intramyocardial oxygen tension (PO2) rose from 13 +/- 3 to 19 +/- 5 mm. Hg when a period of linear flow was followed by a period of pulsatile flow (p less than 0.025). Similarly in the CIRC-supplied area, intramyocardial carbon dioxide (PCO2) decreased from 128 +/- 12 to 99 +/- 12 mm. Hg (p less than 0.005) with conversion from linear to pulsatile flow. Myocardial blood flow (microsphere technique) to endocardial and epicardial layers of the CIRC-supplied area was significantly greater (p less than 0.05) during pulsatile than during linear perfusion. In contrast, when periods of pulsatile bypass were followed by periods of linear perfusion, myocardial PO2 fell from 25 +/- 6 to 9 +/- 3 (less than 0.02) and myocardial PCO2 rose from 82 +/- 12 to 154 +/- 12 mm. Hg (p less than 0.001). These data suggest that (1) fibrillation-induced regional ischemia distal to a critical coronary stenosis can be reduced by pulsatile perfusion during bypass and (2) the mechanism for the reduction in regional ischemia is improved myocardial blood flow.

This article has been cited by other articles:

				G. S. Kassab, M. Kostelec, G. D. Buckberg, J. Covell, A. Sadeghi, and J. I.E. Hoffman Myocardial protection in the failing heart: II. Effect of pulsatile cardioplegic perfusion under simulated left ventricular restoration J. Thorac. Cardiovasc. Surg., October 1, 2006; 132(4): 884 - 890. [Abstract] [Full Text] [PDF]

				R. S. Poston, J. Gu, D. Prastein, F. Gage, J. W. Hoffman, M. Kwon, A. Azimzadeh, R. N. Pierson III, and B. P. Griffith Optimizing Donor Heart Outcome After Prolonged Storage With Endothelial Function Analysis and Continuous Perfusion Ann. Thorac. Surg., October 1, 2004; 78(4): 1362 - 1370. [Abstract] [Full Text] [PDF]

				G. K. Jett ABIOMED BVS 5000: Experience and Potential Advantages Ann. Thorac. Surg., January 1, 1996; 61(1): 301 - 304. [Abstract] [Full Text]

				J. M. Murkin, J. S. Martzke, A. M. Buchan, C. Bentley, and C. J. Wong A RANDOMIZED STUDY OF THE INFLUENCE OF PERFUSION TECHNIQUE AND pH MANAGEMENT STRATEGY IN 316 PATIENTS UNDERGOING CORONARY ARTERY BYPASS SURGERY:I. Mortality and cardiovascular morbidity J. Thorac. Cardiovasc. Surg., August 1, 1995; 110(2): 340 - 348. [Abstract] [Full Text]