HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Heineman, F. W. Articles by Ninomiya, J. Search for Related Content PubMed PubMed Citation Articles by Heineman, F. W. Articles by Ninomiya, J.

The Journal of Thoracic and Cardiovascular Surgery, Vol 81, 851-859, Copyright © 1981 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Regional and transmural myocardial temperature distribution in cold chemical cardioplegia: significance of critical coronary arterial stenosis

FW Heineman, DC MacGregor, GJ Wilson and J Ninomiya

There is a growing recognition of discrepancies in myocardial temperatures during cold chemical cardioplegia. This study was designed to determine the extent to which coronary arterial stenosis just sufficient to abolish vasodilatory reserve in the working heart, but still compatible with myocardial viability ("critical stenosis"), limits heat transfer from the heart during cardioplegic infusion compared to complete coronary occlusion and no stenosis (control). In nine dogs, temperatures were measured from the subepicardium, midwall, and subendocardium of the left ventricle in the distributions of the circumflex (CCA) and left anterior descending (LAD) coronary arteries plus the aortic root, septum, mediastinum, and ventricular cavities. Cardiopulmonary bypass was instituted with core cooling to 28 degrees C. Three infusions of cold (4 degrees C), radioactive microsphere- labeled, potassium chloride arresting solution were periods of reperfusion. The data (mean +/- SEM) indicate that myocardial cooling was transmurally uniform under all conditions, but was significantly impaired (p less than 0.01) in the CCA region by both critical stenosis (17.4 degrees +/- 1.2 degrees C) and occlusion (23.6 degrees +/- 0.4 degrees C) compared to control (8.3 degrees +/- 0.5 degrees C), because of reduced perfusate flow to regional tissues (4 = 0.62, p less than 0.001). These findings show that coronary artery lesions, including those compatible with myocardial viability, impose a severe constraint on myocardial heat transfer and point to a need for improved cardioplegic technique.

This article has been cited by other articles:

				J W Mulholland The Great Britain and Ireland perspective: current perfusion safety issues, preparing for the future Perfusion, July 1, 2005; 20(4): 217 - 225. [Abstract] [PDF]

				G. S. Aldea, D. Hou, J. D. Fonger, and R. J. Shemin Inhomogeneous and complementary antegrade and retrograde delivery of cardioplegic solution in the absence of coronary artery obstruction J. Thorac. Cardiovasc. Surg., February 1, 1994; 107(2): 499 - 504. [Abstract] [Full Text]

				G. Noera, C. Massini, R. Lodi, and G. Baggio Normothermic blood cardioplegia reperfusion plus nifedipine after cardioplegic arrest: experimental study with a new delivery set Perfusion, July 1, 1987; 2(3): 185 - 194. [Abstract] [PDF]