PMID: 12822639Jun 26, 2003Paper

Fetal myocardial protection is markedly improved by reduced cardioplegic calcium content

The Annals of Thoracic Surgery
Sunil P MalhotraF L Hanley


Fetal cardiac surgery holds a clear therapeutic benefit in the treatment of lesions that increase in complexity due to pathologic blood flow patterns during development. Fetal and neonatal myocardial physiology differ substantially, particularly in the regulation of myocardial calcium concentration. To examine issues of calcium homeostasis and fetal myocardial protection, a novel isolated biventricular working fetal heart preparation was developed. Hearts from 20 fetal lambs, 115 to 125 days gestation, were harvested and perfused with standard Krebs-Henseleit (K-H) solution. The descending aorta was ligated distal to the ductal insertion and the branch pulmonary arteries were ligated to mimic fetal cardiovascular physiology. Hearts were arrested for 30 minutes with normocalcemic (n = 8), hypocalcemic (n = 6), or hypercalcemic (n = 6) cold crystalloid cardioplegia before reperfusion with K-H solution. Compared with normocalcemic cardioplegia, hypocalcemic cardioplegia improved preservation of left ventricular (LV) systolic function (88% +/- 2.2% vs 64% +/- 15% recovery of end-systolic elastance, p = 0.02), diastolic function (12% +/- 21% vs 38% +/- 11% increase in end-diastolic stiffness, p = 0.04), and myocardial contractility ...Continue Reading


Nov 1, 1986·Journal of the American College of Cardiology·L D AllanM J Tynan
Jun 1, 1987·Circulation Research·V MahdaviB Nadal-Ginard
Jan 1, 1985·Journal of the American College of Cardiology·N H Silverman, M S Golbus
Feb 1, 1994·The Annals of Thoracic Surgery·F L Hanley
Jan 4, 2001·American Journal of Surgery·M R Harrison

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