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The Journal of Thoracic and Cardiovascular Surgery, Vol 102, 684-687, Copyright © 1991 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
YF Chen, YT Lin and SC Wu
The purpose of this study was to examine the selective and differential
natures of ischemic injuries among three cardiac chambers (right atrium,
right ventricle, and left ventricle) from the viewpoint of ultrastructural
morphometric study. Twenty consecutive adult patients undergoing cardiac
operations were studied. The duration of aortic crossclamp time varied from
36 to 142 minutes (mean 83.4 +/- 36.4 minutes). Two serial specimens
(preischemic and ischemic) were obtained from the right atrium, the right
ventricle, and the left ventricle, respectively. A total of 120 biopsy
specimens was obtained from these 20 patients. The average mitochondrial
surface area of the left ventricle was 0.308 +/- 0.062 micron 2 in the
preischemic stage and 0.352 +/- 0.083 microns 2 in the ischemic stage. This
represented a 14.3% increase in mitochondrial surface area after ischemic
injury (p less than 0.01). The mitochondrial surface area of the right
ventricle showed an average increase of 43.7%, from 0.252 +/- 0.036 micron
2 in the preischemic stage to 0.362 +/- 0.087 micron 2 in the ischemic
stage (p less than 0.0005). With respect to the mitochondrial surface area
of the right atrium, there was an increase of 88.0%, from 0.217 +/- 0.044
micron 2 in the preischemic stage to 0.408 +/- 0.084 micron 2 (p less than
0.0005). The difference of mitochondrial swelling among three chambers was
statistically significant (right atrium versus right ventricle versus left
ventricle, p less than 0.0005). Moreover, the differences of mitochondrial
swelling between any two chambers were also highly significant (right
atrium versus right ventricle, p less than 0.0005; right ventricle versus
left ventricle, p less than 0.01; right atrium versus left ventricle, p
less than 0.0005). In conclusion, our findings suggest that from the
viewpoint of ultrastructural morphometric study myocardial injury after an
average of 83 minutes of ischemic arrest is poorer in the right chambers of
the heart than in the left ventricle, with the right atrium having the
poorest preservation.
ARTICLES
Inconsistent effectiveness of myocardial preservation among cardiac chambers during hypothermic cardioplegia
Department of Surgery, Kaohsiung Medical College, Taiwan, Republic of China.
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