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J Thorac Cardiovasc Surg 1997;113:462-466
© 1997 Mosby, Inc.

SURGERY FOR CONGENITAL HEART DISEASE

EFFECT OF GLUTAMATE-ASPARTATE REPERFUSION ON POSTISCHEMIC NEONATAL MYOCARDIUM

Supported by The Telethon Clinical Investigative Initiatives, British Columbia's Children's Hospital, and the Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada.

Received for publication July 9, 1996 revisions requested August 19, 1996; revisions received Oct. 18, 1996 accepted for publication Nov. 5, 1996. Address for reprints: S. S. Sett, MD, Cardiovascular Surgery, Rm. 3G63, British Columbia Children's Hospital, 4480 Oak St., Vancouver, British Columbia, Canada V6H 3V4.

Abstract

Objective: We postulated that L-glutamate– and L-aspartate–enriched perfusate would improve functional recovery of postischemic neonatal rabbit hearts. Methods: Isolated working neonatal rabbit hearts were perfused with Krebs-Henseleit buffer and then subjected to 1 hour of hypothermic cardioplegic arrest with St. Thomas' Hospital solution. Hearts were then reperfused with L-glutamate– and L-aspartate–enriched (20 mmol/L) Krebs-Henseleit buffer (AA-enriched Krebs-Henseleit buffer). Hearts reperfused with Krebs-Henseleit buffer alone acted as controls (experiment A). Another group of hearts underwent a similar protocol but were reperfused with the AA-enriched Krebs-Henseleit buffer with correction of the sodium content (experiment B). Results: Hearts reperfused with AA-enriched Krebs-Henseleit buffer showed a significant decrease in aortic flow at both 15 (p = 0.04) and 30 (p = 0.025) minutes compared with controls. Arrhythmias were frequent. Sodium content of the AA-enriched Krebs-Henseleit buffer was 174 ± 0.5 mmol/L. In experiment B, hearts reperfused with the AA-enriched Krebs-Henseleit buffer with correction of the sodium content exhibited no difference in aortic flow and cardiac output at either 15 or 30 minutes (p = 0.95 and 0.5 and 0.48 and 0.78, respectively) compared with controls. No arrhythmias were observed. The sodium content of the AA-enriched Krebs-Henseleit buffer was 146 ± 0.7 mmol/L. Conclusions: A beneficial effect on functional recovery of neonatal hearts reperfused with AA-enriched Krebs-Henseleit buffer was not demonstrated.

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