Myocardial protection with cold, ischemic, potassium-induced cardioplegia

Roe, Benson B.; Hutchinson, J. Ciaran; Fishman, Noel H.; Ullyot, Daniel J.; Smith, Daniel L.

doi:10.1016/s0022-5223(19)39915-5

Cited by 176 publications

(13 citation statements)

References 13 publications

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“…The significantly lower serum levels of ASAT in the cardioplegic-hypothermic group than in the controls during the first 2 days postoperatively ( Table 4) also indicate that (HEARSE et al 1976, LAKS et al 1978, SCHAFF et al 1978. Clinical results have also been favourable, as well as the findings in assessments of myocardial performance curves and cytochemical studies in patients (ROE et al 1977, BRAIMBRIDCE et al 1977, WEISEL et al 1978. The effects of cardioplegia and topical hypothermia have been found to be additive (HEARSE et al 1976, NELSON et al 1976, WEISEL et al 1978.…”

Section: Discxjssionmentioning

confidence: 93%

Myocardial Performance Early After Aorto‐Coronary Bypass Surgery Cardioplegic Arrest Versus Coronary Perfusion

Tydén

Johansson

Nyström

1979

Acta Anaesthesiol Scand

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Haemodynamic adaptation was studied during the first 10 h after aorto-coronary bypass surgery. In a control group of 12 patients the heart was fibrillating and perfused during cardiopulmonary bypass (at 30 degrees C), and in 11 patients cold cardioplegic arrest was used. The first 4--5 h were characterized by rewarming, with increasing oesophageal temperature, cutaneous vasoconstriction and elevated systemic vascular resistance (SVR). A phase of vasodilation followed. In the control group the oxygen uptake index increased by 57% during rewarming, but the cardiac index (CI) was constant (about 2.9 l . min-1.m-2). The arterio-venous oxygen content difference (AVDo2) therefore increased (max. 3.0 mmol . l-1). The postoperative left ventricular performance was better and the serum levels of aspartate aminotransferase (ASAT) during the first 2 days postoperatively were lower in the cardioplegic patients than in the controls, indicating more efficient myocardial preservation. In the cardioplegic-hypothermic group, CI was constant at about 3.2 l . min-1.m-2 (significantly higher than in the control group) and AVDo2 remained normal during the rewarming period. The heart rate was lower initially in the cardioplegic patients than in the controls, implying a favourable influence on myocardial oxygen consumption. The better myocardial function in the cardioplegic-hypothermic group was associated with an only moderately increased SVR. This suggests that the elevated SVR in the control group could have been due to myocardial depression.

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Section: Discxjssionmentioning

confidence: 93%

Myocardial Performance Early After Aorto‐Coronary Bypass Surgery Cardioplegic Arrest Versus Coronary Perfusion

Tydén

Johansson

Nyström

1979

Acta Anaesthesiol Scand

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“…Myocardial protection was achieved by using cold crystalloid antegrade Roe's solution [ 11 ] , at the time of organ harvesting. This formula has been used since the first procedure in 1992 until the present day.…”

Section: Methodsmentioning

confidence: 99%

Pediatric and Congenital Heart Transplant: Twenty-year Experience in a Terciary Brazilian Hospital

Miana¹,

Azeka²,

Canêo³

et al. 2014

Revista Brasileira De Cirurgia Cardiovascular

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IntroductionCardiac transplantation remains the gold standard for end-stage cardiomyopathies and congenital heart defects in pediatric patients.ObjectiveThis study aims to report on 20 years of experience since the first case and evaluate our results.MethodsWe conducted a retrospective analysis of the database and outpatient follow-up. Between October 1992 and April 2012, 109 patients underwent 114 transplants. 51.8% of them being female. The age of patients ranged from 12 days to 21 years with a mean of 8.8±5.7 years and a median of 5.2 years. The underlying diagnosis was dilated cardiomyopathy in 61.5%, congenital heart disease in 26.6% and restrictive cardiomyopathy in 11.9%. All patients above 17 years old had congenital heart disease.ResultsSurvival rate at 30 days, 1, 5, 10, 15, and 20 years were 90.4%, 81.3%, 70.9%, 60.5%, 44.4% and 26.7%, respectively. Mean cold ischemic time was 187.9 minutes and it did not correlate with mortality (P>0.05). Infectious complications and rejection episodes were the most common complications (P<0.0001), occurring, respectively, in 66% and 57.4% of the survivors after 10 years. There was no incidence of graft vascular disease and lymphoproliferative disease at year one, but they affected, respectively, 7.4% and 11% of patients within 10 years.ConclusionTwenty-year pediatric heart transplant results at our institution were quite satisfactory and complication rates were acceptable.

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“…Myocardial damage during cardiac surgery is the most important cause of mortality and morbidity. Cardioplegia has been used for many years in cardiac surgery for myocardial protection due to systemic and local hypothermia [1,2]. Cardioplegia solution, which is the technique of providing elective and chemically cardiac arrest, was first applied in 1955 by Melrose with potassium [3].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the cardioprotective effects of crystalloid del Nido cardioplegia solution via a rapid and accurate cardiac marker: heart-type fatty acid-binding protein

Kirişçi¹,

Koçarslan²,

Aykan³

et al. 2020

Turk J Med Sci

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Background/aim: Our aim in this study was to compare the efficacy and safety of crystalloid del Nido solution and cold blood cardioplegia solution on clinical and laboratory parameters. Materials and methods: Sixty patients who underwent elective coronary bypass operation between July 2019 and January 2020 were included in our study. Patients were divided into 2 groups of 30 patients using del Nido solution (DNS) and cold blood cardioplegia solution (CBCS), which were given for cardiac arrest. Demographic data, preoperative, postoperative 0th h, 6th h and 4th day creatine kinase myocardial band (CK-MB) and troponin I values were compared with a specific cardiac enzyme heart-type fatty acid-binding protein (H-FABP). Results: We found that aortic cross clamp duration and cardiopulmonary bypass (CPB) time were shorter in patients using del Nido solution than cold blood cardioplegia solution (57.30 ± 23.57 min, 76.07 ± 27.18 min, P = 0.006) (95.07 ± 23.06 min, 114.13 ± 33.93, P = 0.014). Total cardioplegia solution volume was higher in the cold blood cardioplegia solution group (1426.67 ± 416.00 vs. 1200 ± 310.73 P = 0.02). Preoperative and postoperative levels of cardiac enzymes including CK-MB, troponin I and H-FABP were comparable in del Nido solution and cold blood cardioplegia solution groups. Conclusion: According to these results, when we compare both demographic data and CK-MB, troponin I and H-FABP levels, both cardioplegia solutions were comparable regarding safety and efficacy in terms of myocardial protection.

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Myocardial protection with cold, ischemic, potassium-induced cardioplegia

Cited by 176 publications

References 13 publications

Myocardial Performance Early After Aorto‐Coronary Bypass Surgery Cardioplegic Arrest Versus Coronary Perfusion

Myocardial Performance Early After Aorto‐Coronary Bypass Surgery Cardioplegic Arrest Versus Coronary Perfusion

Pediatric and Congenital Heart Transplant: Twenty-year Experience in a Terciary Brazilian Hospital

Evaluation of the cardioprotective effects of crystalloid del Nido cardioplegia solution via a rapid and accurate cardiac marker: heart-type fatty acid-binding protein

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