Abstract
Despite of many reports about the detrimental effects of intermittend ischemia induced by ventricular fibrillation as a method of myocardial protection this method is still used during coronary surgery (1, 2, 3, 4, 5, 6). The proponents of this method argue that the duration of ischemia is shorter than during cardioplegic arrest (7) and that this method is as safe as cardioplegic arrest (8, 9). In our study we compared myocardial protection due to cardioplegic arrest and intermittend ischemia during coronary surgery. The quality of myocardial protection was estimated by electronmicroscopic studies of myocardial biopsies taken from patients during coronary surgery.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
S.J. Phillips, R.H. Zeff, C. Kongtahworn, L.A. Iannone, T.M Brown and D.F. Gordon, Anoxic hypothermic cardioplegia compared to intermittent anoxic fibrillatory cardiac arrest. Clinical and metabolic experience with 1080 patients, Ann Surg 190: 80 (1979)
E. Hjelms and E. Steiness, Myocardial protection in coronary artery bypass surgery. A study comparing cold cardioplegia and intermittent aortic cross clamping, J Cardiovasc Surg 23: 403 (1982)
W.R. Chitwood Jr., R.C. Hill, J.D. Sink and A.S. Wechsler, Diastolic ventricular properties in patients during coronary revascularization. Intermittent ischemic arrest versus cardioplegia, J Thorac Cardiovasc Surg 85: 595 (1983)
H. Vejlstedt, K. Andersen, B. Husum, B.F. Hansen, T. Palm and J. Arnbjerg, Myocardial preservation during anoxic arrest, J Thorac Cardiovasc Surg 16: 175 (1982)
M.G. Adappa, L.B. Jacobson, R. Hetzer, J.D. Hill, B. Kamm and W.J. Kerth, Cold hyperkalemic cardiac arrest versus intermittent aortic cross-clamping and topical hypothermia for coronary bypass surgery, J Thorac Cardiovasc Surg 75: 171 (1978)
D.M. Folette, D.G. Mulder, J.V. Malony Jr. and G.D. Buckberg, Advantages of blood cardioplegia over continuous coronary perfusion or intermittent ischemia, J Thorac Cardiovasc Surg 76: 604 (1978)
A. Reikram, G. Semb, S. Landaas, K. Midtb and E. Sivertssen, Comparison of five different operative procedures: cold chemical cardioplegia versus intermittent cross-clamping of the aorta, Scand J Thorac Cardiovasc Surg 16: 169 (1982)
H.E. Wilson, M.L. Dalton, R.J. Kiphart, and W.M. Allison, Increased safety of aorto-coronary artery bypass surgery with induced ventricular fibrillation to avoid anoxia, J Thorac Cardiovasc Surg 64: 193 (1972)
J.L. Cox, R.W. Anderson, H.J. Pass, W.D. Currie, C.R. Roc, E. Mikat, A.S. Wechsler, and D.C. Sabiston, The safety of induced ventricular fibrillation during cardiopulmonary bypass in non hypertrophied hearts, J Thorac Cardiovasc Surg 74: 423 (1977)
C.J. Preusse, M.M. Gebhard, and H.J. Bretschneider, Myocardial equilibration process and myocardial energy turnover during initiation of artificial cardiac arrest with cardioplegic solution - reasons for a sufficiently long cardioplegic perfusion, Thorac Cardiovasc Surgeon 29: 71 (1981)
P. Jynge, D.J. Hearse, J. deLeiris, D. Fenvray and M.V. Braimbridge, Protection of the ischemic myocardium, J Thorac Cardiovasc Surg 76: 2 (1978)
J. Schaper and W. Schaper, Ultrastructural correlations of reduced cardiac function in human heart disease, Eur Heart J 4 (Suppl A): 35 (1983)
J. Schaper, Die Ultrastruktur des Myocards bei Ischämie, Habilitationsschrift, Justus-Liebig-Universität Gießen (1980)
C.E. Hottenrot, B. Towers, J.J. Kurkji, J.F. Maloney and G.D. Buckberg, The kazard of ventricular fibrillation in hypertrophied ventricles during cardiopulmonary bypass, J Thorac Cardiovasc Surg 66: 742 (1973)
S. Levitzky, R.L. Wright, S.R. Nodem, C. Holland, K. Roper, R. Engelman and H. Feinberg, Does intermittent coronary perfusion offer greater myocardial protection than continuous aortic cross-clamping? Surgery 82: 51 (1977)
H.J. Smith, K.M. Kent and S.E. Epstein, Contractile damage from reperfusion after transient ischemia in the dog, J Thorac Cardiovasc Surg 75: 452 (1978)
G.D. Buckberg, J.R. Brazier, R.L. Nelson, S.M. Goldstein, D.H. McConnel and N. Cooper, Studies of the effects of hypothermia an regional myocardial blood flow and metabolism during cardiopulmonary bypass. 1. The adequately perfused beating, fibrillating and arrested heart, J Thorac Cardiovasc Surg 73: 84 (1977)
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1986 Plenum Press, New York
About this chapter
Cite this chapter
Görlach, G., Scheld, H.H., Mulch, J., Schaper, J., Hehrlein, F.W. (1986). Ultrastructure of the Human Myocardium after Intermittent Ischemia Compared to Cardioplegia. In: Brautbar, N. (eds) Myocardial and Skeletal Muscle Bioenergetics. Advances in Experimental Medicine and Biology, vol 194. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-5107-8_33
Download citation
DOI: https://doi.org/10.1007/978-1-4684-5107-8_33
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4684-5109-2
Online ISBN: 978-1-4684-5107-8
eBook Packages: Springer Book Archive