Metabolic Arrest of the Ischemic Heart

Tyers, G. Frank O.

doi:10.1016/s0003-4975(10)63858-1

Cited by 27 publications

(3 citation statements)

References 5 publications

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“…These findings may be of interest for cardiac surgery where cold calcium-free cardioplegic solutions are widely used to induce cardiac arrest. It has been claimed (Tyers, 1975;Jynge, Hearse and Braimbridge, 1977) that the use of these solutions may adversely affect membrane permeability and integrity, and may predispose the heart to some form of the calcium paradox. It is worth noting that Ashraf et al (1982) found a complete inhibition of the calcium paradox injury by a combination of diltiazem treatment and hypothermia.…”

Section: Discussionmentioning

confidence: 99%

Calcium paradox and calcium entry blockers

Ruigrok¹,

Slade²,

Nayler³

et al. 1984

Developments in Cardiovascular Medicine

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Section: Discussionmentioning

confidence: 99%

Calcium paradox and calcium entry blockers

Ruigrok¹,

Slade²,

Nayler³

et al. 1984

Developments in Cardiovascular Medicine

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“…A strategy of ‘’polarized arrest’’ is based on the application of pharmacological agents that maintain the polarity of the membrane close to the potential at rest. These compounds appear to be superior in comparison to hyperkalemic solutions due to a capacity to decrease energy consumption and metabolic demands of the heart since the calcium channels are not activated at these values of membrane polarity [ 28 , 29 ]. The most frequently used polarized agents involve Na + -channel blockers, ATP-sensitive K + (K-ATP) channel openers, calcium antagonists, and esmolol, etc.…”

Section: Cardioplegia As a Tool For Heart Preservation Throughout His...mentioning

confidence: 99%

Cardioplegia in Open Heart Surgery: Age Matters

Bradić

Andjić

Jeremić

et al. 2023

JCM

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Introduction: Cardioplegia is a pharmacological approach essential for the protection of the heart from ischemia–reperfusion (I–R) injury. Over the years, numerous cardioplegic solutions have been developed, with each cardioplegic approach having its advantages and disadvantages. Cardioplegic solutions can be divided into crystalloid and blood cardioplegic solutions, and an experienced surgeon chooses the type of solution based on the individual needs of patients in order to provide optimal heart protection. Importantly, the pediatric immature myocardium is structurally, physiologically, and metabolically different from the adult heart, and consequently its needs to achieve cardioplegic arrest strongly differ. Therefore, the present review aimed to provide a summary of the cardioplegic solutions available to pediatric patients with a special focus on emphasizing differences in heart injury after various cardioplegic solutions, the dosing strategies, and regimens. Material and methods: The PubMed database was searched using the terms cardioplegia, I–R, and pediatric population, and studies that investigated the influence of cardioplegic strategies on markers of cardiac muscle damage were further analyzed in this review. Conclusions: A large body of evidence suggested more prominent benefits achieved with blood compared to those with crystalloid cardioplegia in pediatric myocardium preservation. However, standardized and uniform protocols have not been established so far, and an experienced surgeon chooses the type of cardioplegia solution based on the individual needs of patients, while the severity of myocardial damage strongly depends on the type and duration of the surgical procedure, overall patient condition, and presence of comorbidities, etc.

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“…The advantage of arrest with normal polarity or hyperpolarization is that the calcium channels are not activated [13] so that oxygen consumption is reduced to a minimum [10].…”

Section: Sodium Channel Blockersmentioning

confidence: 99%

Solução cardioplégica polarizante: estado da arte

Oliveira¹,

Godoy²,

Braile³

et al. 2005

Rev Bras Cir Cardiovasc

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The meaning of the term "cardioplegia" is "lesion, attack, wound or blow", very different to how it is most commonly understood in most heart centers, where it relates to cardiac protection. Thus, "cardioplegic solution" is better defined as a solution capable of inducing controlled cardiac arrest. Cardiac arrest induced by cardioplegic solutions can occur by hyperpolarization, depolarization or by inhibiting the calcium channels of the myocardial fibers. This paper discusses hyperpolarizing cardioplegic solutions, which arrest the heart in the diastolic phase, thus decreasing the ATP depletion and improving the conditions of the heart to be reanimated at the end of the procedure.

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Metabolic Arrest of the Ischemic Heart

Cited by 27 publications

References 5 publications

Calcium paradox and calcium entry blockers

Calcium paradox and calcium entry blockers

Cardioplegia in Open Heart Surgery: Age Matters

Solução cardioplégica polarizante: estado da arte

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