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The Journal of Thoracic and Cardiovascular Surgery, Vol 92, 255-263, Copyright © 1986 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
M Masuda, K Yonenaga, K Shiki, S Morita, H Kohno and K Tokunaga
The lack of adequate myocardial preservation because of maldistribution of
cardioplegic solution in coronary artery disease remains a perplexing
problem. We compared two methods of cardioplegic delivery in dogs:
antegrade aortic root perfusion (Group I) and retrograde coronary sinus
perfusion (Group II). Metabolic changes and regional function in the
coronary occlusion model, in which the left anterior descending artery was
occluded at its prediagonal portion, were studied. In the distribution of
the occluded coronary artery, adenosine triphosphate and total adenine
nucleotides at the end of 120 minutes of ischemia were preserved better in
Group II (16.80 and 22.94 mumol/gm dry weight) than in Group I (11.06 and
16.19 mumol/gm dry weight, p less than 0.05). Lactate accumulation tended
to be higher in Group I than in Group II (114.0 and 87.2 mumol/gm dry
weight, respectively; not significant). Percent recovery of segmental
shortening was also better in Group II than in Group I (100% and 22.3% at
the same left atrial pressure, 4 mm Hg; p less than 0.01). In the region
supplied by the intact coronary artery, there were no significant
differences between the two groups with regard to metabolic changes and
regional function. These observations suggest that retrograde cardioplegic
perfusion via the coronary sinus is preferable for surgically treatment of
severe coronary artery disease.
ARTICLES
Myocardial protection in coronary occlusion by retrograde cardioplegic perfusion via the coronary sinus in dogs. Preservation of high-energy phosphates and regional function
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