Clinical Experiences with Induced Cardiac Arrest During Intracardiac Surgical Procedures*

Lam, Conrad R.; Gahagan, Thomas; Sergeant, Charles; Green, Edward

doi:10.1097/00000658-195709000-00012

Cited by 24 publications

(9 citation statements)

References 6 publications

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“…The term cardioplegia ( cardio , heart and plegia , paralysis) was first introduced by Lam in 1957 (Lam et al, 1957), yet the method of arrest has its roots in the early experiments of British physiologist Sidney Ringer using the frog heart (Figure 2). In 1883 Ringer reported that potassium chloride was a powerful arresting agent (Ringer, 1883), a serendipitous discovery like many in science and medicine (Dobson, 2005).…”

Section: Introductionmentioning

confidence: 99%

“…However, it was not until 1955 that Lam and colleagues in the US administered an intraventricular injection of KCl (667 mEq/L) to induce cardiac arrest in hypothermic dogs (without bypass) (Lam et al, 1955). Lam's group subsequently abandoned the KCl method because of refractory ventricular fibrillation (VF) and myocardial damage during reperfusion and reanimation (Effler et al, 1956; Lam et al, 1957; Schaff et al, 1978; Shiroishi, 1999) (Figure 2). Lam also tried acetylcholine (10 mg/kg body wt) to induce arrest and while the heart would beat more forcefully during reanimation than when KCl was used, the incidence of VF was higher (Weirich, 1962).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Hyperkalemic cardioplegia for adult and pediatric surgery: end of an era?

Dobson¹,

Faggian²,

Onorati³

et al. 2013

Front. Physiol.

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Despite surgical proficiency and innovation driving low mortality rates in cardiac surgery, the disease severity, comorbidity rate, and operative procedural difficulty have increased. Today's cardiac surgery patient is older, has a “sicker” heart and often presents with multiple comorbidities; a scenario that was relatively rare 20 years ago. The global challenge has been to find new ways to make surgery safer for the patient and more predictable for the surgeon. A confounding factor that may influence clinical outcome is high K+ cardioplegia. For over 40 years, potassium depolarization has been linked to transmembrane ionic imbalances, arrhythmias and conduction disturbances, vasoconstriction, coronary spasm, contractile stunning, and low output syndrome. Other than inducing rapid electrochemical arrest, high K+ cardioplegia offers little or no inherent protection to adult or pediatric patients. This review provides a brief history of high K+ cardioplegia, five areas of increasing concern with prolonged membrane K+ depolarization, and the basic science and clinical data underpinning a new normokalemic, “polarizing” cardioplegia comprising adenosine and lidocaine (AL) with magnesium (Mg2+) (ALM™). We argue that improved cardioprotection, better outcomes, faster recoveries and lower healthcare costs are achievable and, despite the early predictions from the stent industry and cardiology, the “cath lab” may not be the place where the new wave of high-risk morbid patients are best served.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hyperkalemic cardioplegia for adult and pediatric surgery: end of an era?

Dobson¹,

Faggian²,

Onorati³

et al. 2013

Front. Physiol.

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show abstract

“…5. Von Lam und seiner Arbeitsgruppe wurde 1955 das Acetylcholin zur Durchführung eines induzierten Herzstillstandes während extrakorporaler Zirkulation in die Klinik eingeführt {Lam et al [34][35][36][37][38][39]). Dabei wurde die experimentell erprobte (Holle et al [24]) hohe Dosierung von 10 mg/kg in 20 ml physiologischer Kochsalzlösung durch Einzelinjektionen in die proximale Aorta nach ihrer Abklemmung angewandt.…”

Section: Ergebnisseunclassified

Klinische Erfahrungen mit der Kardioplegie nach Bretschneider

Jc¹,

Schramm²,

Gehl³

et al. 1971

Thorac cardiovasc Surg

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“…Moulder et al (1956) also reported success in the use of acetylcholine to inhibit cardiac contractions in dog and humans under hypothermia. Lam et al (1957Lam et al ( , 1957aLam et al ( , 1958, using acetylcholine as the cardioplegic agent, reported on its clinical safety and low incidence of ventricular fibrillation during recovery. It was noted however, that during arrest with acetylcholine the heart might beat if the ventricle wall was stimulated mechanically by forceps or needles.…”

Section: Review Of the Literaturementioning

confidence: 99%

Comparative cardio-inhibitory effects of certain cyclohexanol and cyclohexylamine derivatives

Kosegarten

DeFeo

DeFanti

1967

Journal of Pharmaceutical Sciences

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Derivatives of cyclohexanol and cyclohexylamine were pharmacologically screened for cardioplegic effects on intact anesthetized rats, and isolated guinea pig hearts. Evaluation of potency was based on the ability to depress rat carotid blood pressure, and to produce cardiac arrest in the isolated guinea pig heart.As a group, the non-ethynyl cyclohexanol derivatives were more potent in producing a hypotensive response, than were the derivatives of cyclohexylamine. trans-2-£-Tolyl-cis-l, 4-cyclohexanediol and trans-2-£-tolyl-trans-l, 5-cyclohexanediol were equally effective and the most active. trans-2-(E.-Chlorophenyl)-N, N-dimethylcyclohexyl~ amine was the least active, and the only compound to produce a pressor response.Conversely, the cyclohexylamines were more potent cardioplegic agents. The cis and trans isomers of 2-(E.-chlorophenyl)-N, N-dimethyl cyclohexylamine were equally the most active with trans-2-£-tolylcis-l, 4-cyclohexanediol the least active. The minimum effective cardioplegic dose of l-ethynyl-trans-2-£-tolylcyclohexanol was also the cardiotoxic dose as the heart failed to recover from arrest.Mechanism studies on spontaneously beating isolated rat atria indicate an antagonistic effect between calcium and the negative inotropic action of these compounds.

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Clinical Experiences with Induced Cardiac Arrest During Intracardiac Surgical Procedures*

Cited by 24 publications

References 6 publications

Hyperkalemic cardioplegia for adult and pediatric surgery: end of an era?

Hyperkalemic cardioplegia for adult and pediatric surgery: end of an era?

Klinische Erfahrungen mit der Kardioplegie nach Bretschneider

Comparative cardio-inhibitory effects of certain cyclohexanol and cyclohexylamine derivatives

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