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 Rousou, J. A. Articles by Das, D. K. Search for Related Content PubMed PubMed Citation Articles by Rousou, J. A. Articles by Das, D. K.

The Journal of Thoracic and Cardiovascular Surgery, Vol 91, 270-276, Copyright © 1986 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Metabolic enhancement of myocardial preservation during cardioplegic arrest

JA Rousou, RM Engelman, L Anisimowicz, S Lemeshow, WA Dobbs, RH Breyer and DK Das

An experimental study was undertaken to evaluate the relative efficacy of oxygenated versus unoxygenated cardioplegic solutions and to determine if the addition of certain metabolically active substrates to cardioplegic solutions had any effect on myocardial preservation. Sixty- one pigs were divided into seven groups of animals (5 to 15 animals per group). The impact of different cardioplegic vehicles, i.e., crystalloid versus the oxygen-carrying vehicles, blood and Fluosol-DA, on preservation of high-energy phosphates (adenosine triphosphate and creatine phosphate) was examined in the first three animal groups. The influence of Krebs cycle intermediates, i.e., glutamate, malate, succinate and fumarate, on adenosine triphosphate and creatine phosphate preservation was evaluated in the other four animal groups. All hearts underwent 120 minutes of hypothermic cardioplegic arrest at 15 degrees C followed by 60 minutes of normothermic reperfusion. Higher adenosine triphosphate and creatine phosphate levels were maintained during arrest when oxygenated solutions were used as the cardioplegic vehicle and when any of the four intermediates were added to the crystalloid cardioplegic solution, especially succinate and fumarate. During reperfusion, however, adenosine triphosphate levels were uniformly lower than control whereas creatine phosphate levels rose to either control levels or higher in all groups. No significant intergroup difference could be identified during reperfusion. These findings lead to the conclusion that the presence of either oxygen or certain Krebs cycle intermediates enhances the protective effect of hyperkalemic hypothermic cardioplegia on high-energy phosphates during the arrest period only. This enhancement is not maintained during the reperfusion period.

This article has been cited by other articles:

				N. Maulik, V. E. Kagan, V. A. Tyurin, and D. K. Das Redistribution of phosphatidylethanolamine and phosphatidylserine precedes reperfusion-induced apoptosis Am J Physiol Heart Circ Physiol, January 1, 1998; 274(1): H242 - H248. [Abstract] [Full Text] [PDF]

				V. Rao, J. Ivanov, R. D. Weisel, J. S. Ikonomidis, G. T. Christakis, and T. E. David PREDICTORS OF LOW CARDIAC OUTPUT SYNDROME AFTER CORONARY ARTERY BYPASS J. Thorac. Cardiovasc. Surg., July 1, 1996; 112(1): 38 - 51. [Abstract] [Full Text]

				E. R. Rosenkranz Substrate Enhancement of Cardioplegic Solution: Experimental Studies and Clinical Evaluation Ann. Thorac. Surg., September 1, 1995; 60(3): 797 - 800. [Abstract] [Full Text]

				A. Marchbank Fluorocarbon emulsions Perfusion, March 1, 1995; 10(2): 67 - 88. [PDF]