PMID: 3747583Sep 1, 1986Paper

Regional blood cardioplegic reperfusion during total vented bypass without thoracotomy: a new concept

The Journal of Thoracic and Cardiovascular Surgery
F OkamotoJ V Maloney

Abstract

This study tests the hypothesis that immediate functional recovery is possible after 2 to 3 hours of regional ischemia by control of the conditions of reperfusion (i.e., total vented bypass) and the composition of the reperfusate (substrate-enriched blood cardioplegic solution) by either central cannulation with thoracotomy or peripheral cannulation without thoracotomy. Total vented bypass could be established successfully in each of 14 experiments (100%) in which the peripheral cannulation method was tested. Regional function (evaluated by ultrasonic crystals in open-chest animals) recovered comparably when substrate-enriched blood cardioplegic solution was given either globally or regionally (46% versus 36%) and total vented bypass was accomplished by either central cannulation or peripheral cannulation technique (i.e., left ventricle decompressed through a transaortic vent catheter, right atrium cannulated through the femoral vein, femoral artery perfusion). In contrast, systolic bulging persisted (-23% control systolic shortening) following normal blood reperfusion in beating, working hearts. Controlled reperfusion (either global or regional) also minimized postischemic edema (81% versus 83% water content, p less than 0.05)...Continue Reading

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