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The Journal of Thoracic and Cardiovascular Surgery, Vol 70, 945-954, Copyright © 1975 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Ischemic contracture of the left ventricle. Production and prevention

DC MacGregor, GJ Wilson, S Tanaka, DE Holness, W Lixfeld, MD Silver, LJ Rubis, W Goldstein, J Gunstensen and WG Bigelow

Ischemic contracture of the left ventricle ("stone heart") is a recognized complication of prolonged periods of interruption of the coronary circulation during open-heart surgery. We have examined the effects of moderate hypothermia (28 degrees C.) and preoperative beta- adrenergic blockade (propranolol, 0.5 mg. per kilogram; 1.0 mg. per kilogram) on contracture development during ischemic arrest of the heart. Four groups of 8 dogs each were placed on total cardiopulmonary bypass, and ischemic arrest of the heart was produced by cross-clamping the ascending aorta and venting the left ventricle. Intramyocardial carbon dioxide tension was continuously monitored by mass spectrometry. When anaerobic energy production ceased, as indicated by a final plateau in the intramyocardial carbon dioxide accumulation curve, the ischemic arrest was terminated and the contractile state of the heart observed. These results are given in the text. We conclude that beta- adrenergic blockade delays, but does not prevent, the onset of ischemic contracture of the left ventricle under normothermic conditions. Moderate hypothermia appears to prevent this complication completely.


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R. A. Berg, V. L. Sorrell, K. B. Kern, R. W. Hilwig, M. I. Altbach, M. M. Hayes, K. A. Bates, and G. A. Ewy
Magnetic Resonance Imaging During Untreated Ventricular Fibrillation Reveals Prompt Right Ventricular Overdistention Without Left Ventricular Volume Loss
Circulation, March 8, 2005; 111(9): 1136 - 1140.
[Abstract] [Full Text] [PDF]


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Copyright © 1975 by The American Association for Thoracic Surgery.