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 Citation Map 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 Ledingham, S. J. Articles by Hearse, D. J. Search for Related Content PubMed PubMed Citation Articles by Ledingham, S. J. Articles by Hearse, D. J.

The Journal of Thoracic and Cardiovascular Surgery, Vol 95, 103-111, Copyright © 1988 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Improved myocardial protection by oxygenation of St. Thomas' Hospital cardioplegic solutions. Studies in the rat

SJ Ledingham, MV Braimbridge and DJ Hearse
Cardiovascular Research, Rayne Institute, St. Thomas' Hospital, London, England.

The effect of oxygenation (100% oxygen) of the St. Thomas' Hospital cardioplegic solutions No. 1 (MacCarthy) and No.2 (Plegisol, Abbott Laboratories, North Chicago, Ill.) was examined in the isolated working rat heart subjected to long periods (3 hours for studies with solution No. 1 and 4 hours for studies with solution No. 2) of hypothermic (20 degrees C) ischemic arrest with multidose (every 30 minutes) cardioplegic infusion. At the aortic infusion point the oxygen tension of the oxygenated solutions (measured at 20 degrees C) was in the range of 320 to 560 mm Hg whereas that of the nonoxygenated solutions was less than 150 mm Hg. Twenty hearts (10 oxygenated and 10 nonoxygenated) were studied for each solution. The studies with solution No. 1 demonstrated that oxygenation led to a significant (p less than 0.05) reduction in the incidence of persistent ventricular fibrillation during postischemic reperfusion. Oxygenation of the cardioplegic solution also improved postischemic functional recovery so that the recovery of aortic flow was improved from 18.7% +/- 8.9% (of its preischemic control level) in the nonoxygenated group to 54.6% +/- 6.6% in the oxygenated group (p less than 0.025). Creatine kinase leakage was also significantly reduced from 27.5 +/- 4.8 to 9.9 +/- 0.6 IU/15 min/gm dry weight (p less than 0.005). Studies with solution No. 2 indicated that protection was better than with solution No. 1, even in the absence of oxygenation. A better degree of functional recovery was obtained after 4 hours of arrest with solution No. 2 than that obtained after only 3 hours of arrest with solution No. 1, and persistent ventricular ventricular fibrillation was never observed with solution No. 2. However, despite the superior performance with solution No. 2, further improvements could be obtained by oxygenation, with that time from the onset of reperfusion to the return of regular sinus rhythm being reduced from 55 +/- 8 to 35 +/- 2 seconds (p less than 0.01), postischemic recovery of aortic flow increasing from 59.8% +/- 7.4% to 85.7% +/- 2.5% (p less than 0.005), and creatine kinase leakage being reduced from 38.1 +/- 7.3 to 16.2 +/- 1.5 IU/15 min/gm dry weight (p less than 0.005). It is concluded that oxygenation of the St. Thomas' Hospital cardioplegic solutions improves their ability to protect the heart against long periods of ischemia and that this is manifested by improved postischemic electrical stability, functional recovery, and reduced creatine kinase leakage.

This article has been cited by other articles:

				L. A. Bockeria, R. R. Movsesyan, D. V. Ryabtsev, and T. R. Grigoryants eComment: Myocardial protection: efficacy of a novel magnesium-basedcardioplegia (RS-C) compared to St Thomas' Hospital cardioplegic solution Interact CardioVasc Thorac Surg, October 1, 2008; 7(5): 749 - 749. [Full Text] [PDF]

				R. Bessho and D. J. Chambers Myocardial protection with oxygenated esmolol cardioplegia during prolonged normothermic ischemia in the rat J. Thorac. Cardiovasc. Surg., August 1, 2002; 124(2): 340 - 351. [Abstract] [Full Text] [PDF]

				G. S. Aldea, H. Mori, W. K. Husseini, R. E. Austin, and J. I. E. Hoffman Effects of increased pressure inside or outside ventricles on total and regional myocardial blood flow Am J Physiol Heart Circ Physiol, December 1, 2000; 279(6): H2927 - H2938. [Abstract] [Full Text] [PDF]

				F. Kuhn-Regnier, J. H. Fischer, S. Jeschkeit, R. Switkowski, o. Bardakcioglu, R. Sobottke, and E. R. de Vivie Coronary oxygen persufflation combined with HTK cardioplegia prolongs the preservation time in heart transplantation Eur J Cardiothorac Surg, January 1, 2000; 17(1): 71 - 76. [Abstract] [Full Text] [PDF]

				M. F. Ibrahim, G. E. Venn, C. P. Young, and D. J. Chambers A clinical comparative study between crystalloid and blood-based St Thomas' hospital cardioplegic solution Eur J Cardiothorac Surg, January 1, 1999; 15(1): 75 - 83. [Abstract] [Full Text] [PDF]

				W. G. Hendren, D. D. O'Keefe, G. A. Geffin, A. G. Denenberg, T. R. Love, and W. M. Daggett Maximal oxygenation of dilute blood Cardioplegic solution Ann. Thorac. Surg., November 1, 1994; 58(5): 1558 - 1559. [Abstract] [PDF]

				U. O. von Oppell, L. M. King, E. F. Du Toit, P. Owen, B. Reichart, and L. H. Opie Effect of pH shifts induced by oxygenating crystalloid cardioplegic solutions Ann. Thorac. Surg., October 1, 1991; 52(4): 903 - 907. [Abstract] [PDF]

				G. A. Geffin, T. R. Reynolds, J. S. Titus, D. D. O'Keefe, and W. M. Daggett Relation of myocardial protection to cardioplegic solution pH: Modulation by calcium and magnesium Ann. Thorac. Surg., October 1, 1991; 52(4): 955 - 964. [Abstract] [PDF]

				A. Lochner, L. Lloyd, W. Brits, and A. Coetzee Oxygenation of cardioplegic solutions: A note of caution Ann. Thorac. Surg., May 1, 1991; 51(5): 777 - 787. [Abstract] [PDF]

				G. Staffan, P. Svenmarker, S. K Haggmark, and K E. Jansson A new method for crystalloid cardioplegic oxygenation Perfusion, April 1, 1991; 6(2): 93 - 97. [Abstract] [PDF]

				J. B. Steinberg, N. E. Doherty, N. A. Munfakh, G. A. Geffin, J. S. Titus, D. C. Hoaglin, A. G. Denenberg, and W. M. Daggett Oxygenated cardioplegia: The metabolic and functional effects of glucose and insulin Ann. Thorac. Surg., April 1, 1991; 51(4): 620 - 629. [Abstract] [PDF]

				M. V. Braimbridge Research and the practicing surgeon Ann. Thorac. Surg., May 1, 1990; 49(5): 694 - 700. [PDF]

				D. Wheeldon, R. Amar, and D. Bethune Oxygenated crystalloid cardioplegia: a new technique Perfusion, October 1, 1989; 4(4): 297 - 301. [PDF]