Advertisement

Myocardial Protection of Hypertrophied Hearts by Administration of Cardioplegia According to Regional Myocardial Temperature

  • G. Görlach
  • H. H. Scheld
  • F. Podzuweit
  • J. Mulch
  • W. Schaper
  • F. W. Hehrlein
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 194)

Abstract

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.

Keywords

Creatine Phosphate Myocardial Protection Aortic Valve Disease Cardioplegic Solution Hypertrophied Heart 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 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
  2. 2.
    J.D. Sink, G.L. Hellom, W.D. Carrie, R.C. Hill, C.O. Olsen, R.N. Jones and A.S. Wechsler, Response of the hypertrophied myocardium to ischemia. J Thorac Cardiovasc Surg, 81: 865 (1981).PubMedGoogle Scholar
  3. 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
  4. 4.
    G.D. Buckberg, A Proposed Solution to the Cardioplegic Controversy, J Thorac Cardiovasc Surg 77: 803 (1979).PubMedGoogle Scholar
  5. 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. 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
  7. 7.
    N. Bleese, V. Döring, P. Valmar, H.J. Krebber, H. Pokar, and G. Rodewald, Clinical Application of Cardioplegia in Aortic-Cross-Clamping Periods Longer than 150 Minutes, Thorac Cardiovasc Surgeon 27: 390 (1979).CrossRefGoogle Scholar
  8. 8.
    P. Jynge, D.J. Hearse, J. deLeiris, D. Fenvray, M.V. Braimbridge, Protection of the ischemic myocardium, J Thorac Cardiovasc Surg 76: 2 (1978).PubMedGoogle Scholar
  9. 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. 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
  11. 11.
    R.C.J. Chiu, P.E. Blundell, M.J. Scott, S. Cain, The importance of Monitoring Intramyocardial Temperature during Hypothermic Myocardial Protection. Ann Thorac Surg 28: 318 (1979).CrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1986

Authors and Affiliations

  • G. Görlach
    • 1
  • H. H. Scheld
    • 1
  • F. Podzuweit
    • 2
  • J. Mulch
    • 1
  • W. Schaper
    • 2
  • F. W. Hehrlein
    • 1
  1. 1.Dept. of Cardiovascular SurgeryJustus-Liebig-UniversityGiessenW.-Germany
  2. 2.Dept. of Experimental CardiologyMax-Planck-Institute for Physiological and Clinical ResearchBad NauheimWest-Germany

Personalised recommendations