The Journal of Thoracic and Cardiovascular Surgery, Vol 76, 2-15, Copyright © 1978 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Protection of the ischemic myocardium. Ultrastructural, enzymatic, and functional assessment of the efficacy of various cardioplegic infusates
P Jynge, DJ Hearse, J de Leiris, D Feuvray and MV Braimbridge
The increasing use of cardioplegic protective infusates for reducing
ischemic tissue injury requires that all infusates be carefully assessed
for any protective or damaging properties. This study describes
ultrastructural, enzymatic, and functional assessments of the efficacy of
three infusates (Bretschneider, Kirsch, and St. Thomas' Hospital) in a rat
heart model of cardiopulmonary bypass and ischemic cardiac arrest. The
study reveals a close concordance of results as assessed by the three
totally different indices of tissue damage. The results also indicate that,
in the rat heart model, the St. Thomas' Hospital solution is an effective
protective agent under all conditions studied but the Bretschneider
solution is effective only under hypothermic conditions and the Kirsch
solution is ineffective under all conditions studied and may exacerbate
tissue injury. The studies further suggest that the potentially damaging
effects of calcium-free myocardial infusates may be due to their induction
of a "calcium paradox."
