Experimental Comparison of Methods for Protecting the Heart During Aortic Occlusion

An experimental evaluation of continuous normothermic, intermittent hypothermic, and intermittent normothermic coronary perfusion

“…This expected conclusion confirmed the impressions of earlier workers (Ebert et al, 1962) who found that protection from anoxia resulted from cooling or intermittent cool perfusion. Examination of the lymph flowing from the heart (Ullal, 1972) suggests that tihe worst damage to the heart comes from normothermic anoxia, less from cooling, and least from continuous normothermic perfusion.…”

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

“…Early postoperative arrhythmias are a frequent complication of adult and pediatric cardiac surgery (Harris et al, 1954; Ebert et al, 1962; Flack et al, 1992; Cohen et al, 1993; Yau et al, 1993; Gaillard et al, 2000; Valsangiacomo et al, 2002). In 1980, Ellis showed that higher potassium concentrations in cardioplegia in humans resulted in a higher number of ventricular arrhythmias following cross-clamp removal, and this was worse at lower temperatures (Ellis et al, 1980).…”

Historical perspectives of The American Association for Thoracic Surgery: Paul A. Ebert (1932-2009)

“…4 He compared simple anoxic arrest with various coronary perfusion and myocardial hypothermia strategies to demonstrate that combining coronary perfusion with cooled blood and external myocardial hypothermia would preserve maximal myocardial function. 5 Dr Ebert subsequently turned his attention to optimizing cardioplegia to improve myocardial preservation during cardiopulmonary bypass, basing his investigation on work that demonstrated the benefit of hypothermia combined with coronary infusion of cold cardioplegic solution. 6 Led by a seminal paper by Drs Ebert and Gay in 1973, potassium-based cold chemical cardioplegia was reintroduced into clinical practice in the United States.…”