Medical College of Wisconsin
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Age and protection of the ischemic myocardium: is alkaline cardioplegia appropriate? Ann Thorac Surg 1993 Mar;55(3):747-55

Date

03/01/1993

Pubmed ID

8452442

DOI

10.1016/0003-4975(93)90287-r

Scopus ID

2-s2.0-0027414545   16 Citations

Abstract

Hypothermic alkaline pharmacologic cardioplegia used in pediatric cardiac surgery may be less than satisfactory despite its benefits in adults. We determined whether the pH (7.8) of standard St. Thomas' II cardioplegic solution contributes to inadequate protection of the ischemic immature heart and whether the effect is age-related. Modified hypothermic St. Thomas' II solution (pH range, 4.8 to 8.8) was compared with hypothermic bicarbonate buffer alone (pH 7.25) in protecting the ischemic immature (7 to 10 days old) and mature (12 months old) rabbit heart. Isolated hearts (n = 6 per group) were perfused with bicarbonate buffer, and aortic flow was measured before hypothermic (14 degrees C) ischemia (immature hearts: 4 hours; mature hearts: 3 hours). Hearts were reperfused, and enzyme leakage and recovery of function were measured. In the immature heart, a bell-shaped dose-response profile was observed for pH and recovery of aortic flow but not for postischemic creatine kinase leakage. Optimal recovery of aortic flow (98% +/- 3%) occurred at pH 6.8, which was greater than protection with hypothermia alone (82% +/- 4%; p < 0.05) and standard St. Thomas' II solution (72% +/- 2%; p < 0.05). In the mature heart, a bell-shaped dose-response curve existed for recovery of aortic flow and a U-shaped curve existed for creatine kinase leakage. Again, optimal recovery of aortic flow (84% +/- 5%), which was superior to that with standard St. Thomas' II solution (60% +/- 8%; p < 0.05), and minimal enzyme leakage also occurred at pH 6.8, as did the least enzyme leakage (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Author List

Baker JE, Boerboom LE, Olinger GN

Author

John E. Baker PhD Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Age Factors
Animals
Bicarbonates
Calcium
Calcium Chloride
Cardioplegic Solutions
Coronary Circulation
Creatine Kinase
Heart
Hydrogen-Ion Concentration
Magnesium
Potassium Chloride
Rabbits
Sodium Chloride
Temperature
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a