Amelioration of the effects of ischemic cardiac arrest by the intracoronary administration of cardioplegic solutions.

Circulation
G J Todd, G F Tyers

Abstract

Interruption of coronary flow during cardiac surgical procedures provides a bloodless flaccid heart and allows precise and rapid correction of complex cardiac defects. However, myocardial damage occurs in direct proportion to the duration of the ischemia. As the induction of cardioplegia simulataneous with the initiation of cardiac ischemia helps to preserve cardiac energy reserves and thus myocardial integrity, the identification of a consistently reliable cardioplegic technique is desirable. Isolated perfused working rat hearts were made ischemic for one hour by aortic cross-clamping and were compared with hearts rendered cardioplegic at the onset of ischemia by the intracoronary administration of 5 ml of a hypothermic solution: 1) Krebs-Henseleit buffer, 2) Ringer's lactate, 3) tetrodotoxin, 4) potassium chloride, or 5) potassium citrate. Cardiac output, heart rate, aortic pressure and coronary flow were determined pre and post-ischemia. When compared to time-matched controls and hearts arrested with potassium or tetrodotoxin, the ischemia and ischemia-Ringer's lactate groups showed significant post cross-clamp depression of all measured parameters. Intracoronary Ringer's lactate, although often used as an adjunct to ischemi...Continue Reading

References

Feb 1, 1970·The Journal of Pathology·C P ChengJ C Wang
Jan 1, 1961·Archives of Surgery·V L WILLMANC R HANLON
May 1, 1964·The Journal of General Physiology·T NARAHASHIW R SCOTT
Jul 2, 1955·Lancet·D G MELROSEJ B BAKER

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Citations

Jul 1, 1980·Canadian Anaesthetists' Society Journal·R R ChatrathD R Walker
Dec 1, 1978·The Annals of Thoracic Surgery·W C ScottD M Conkle
Mar 1, 1978·The Journal of Surgical Research·H R KayM T McEnany

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