Myocardial Protection of Hypertrophied Hearts by Administration of Cardioplegia According to Regional Myocardial Temperature
Hypertrophied hearts are known to be extremely vulnerable to ischemia, because of their reduced content of high energy phosphates (1, 2, 3). The reduction of myocardial temperature is one of the most important factors of myocardial protection during heart arrest (4, 5). Cardioplegic solutions of different composition are used in our hospital. To test, which of them are able to protect hypertrophied hearts in a sufficient amount, we studied myocardial protection in patients undergoing aortic valve surgery. According to regional myocardial temperature we intermittently infused cardioplegia so that the temperature of the heart did not increase above 15°C in any region of the heart. Myocardial protection was estimated by measuring the high energy phosphate and lactate content of the myocardium.
KeywordsCreatine Phosphate Myocardial Protection Aortic Valve Disease Cardioplegic Solution Hypertrophied Heart
Unable to display preview. Download preview PDF.
- 1.S.R.K. Iyengar, S. Ramchand, E.J.P. Chavette, C.K.S. Iyengar, and K.G. Lynn, Anoxic cardiac arrest. An experimental and clinical study of its effects. Part I, J Thorac Cardiovasc Surg 82: 692 (1981).Google Scholar
- 3.R.N. Jones, W.D. Currie, C.O. Olsen, R.B. Peyton, P. van Trigt, and A.S. Wechsler, Recovery of metabolic function in hypertrophied canine hearts following global ischemia. Circulation 62 Suppl 3: 80 (1980).Google Scholar
- 5.W.A. Lell, E. Buttner, Myocardial Preservation during Cardiopulmonary Bypass. In: A.J. Kaplan: Cardiac Anesthesia Volume II, pp 525–551, Grune & Stratton, New York (1983).Google Scholar
- 6.C.J. Preusse, M.M. Gebhard, J.J. Bretschneider, Myocardial equilibration process and myocardial energy turnover during imitation of artificial cardiac arrest with cardioplegic solution - reasons for a sufficiently long cardioplegic perfusion. Thorac Cardiovasc Surgeon 29: 71 (1981).CrossRefGoogle Scholar
- 9.H.J. Bretschneider, G. Hübner, D. Knoll, B. Lohr, H. Nordeck, and P.G. Spieckermann, Myocardial resistance and biochemial basis, J Cardiovasc Surg 16: 241 (1975).Google Scholar
- 10.A.S. Wechsler, Deficiencies of Cardioplegia — hypertrophied Ventricle. A Textbook of Clinical Cardioplegia. R.M. Engelmann, S. Levitzky (ed), Futura Publishing Company Mount Lisco, New York 1982; 381.Google Scholar