Energy demand of cardioplegically perfused human hearts

J Cardiovasc Surg (Torino). 1985 Nov-Dec;26(6):558-63.

Abstract

Human adult hearts with aortic valve disease (n = 20) and hypertrophic obstructive cardiomyopathy (n = 1) were perfused intraoperatively with cold histidine buffered Bretschneider solution. During a seven minute cardioplegic perfusion the temperature level, the electrolyte level, the resistance of the left (LCA) and right coronary artery (RCA), and myocardial O2 consumption were analysed. Equilibration of K+ was terminated shortly after the start of the perfusion while Na+ equilibration lasted for about 5 minutes. Resistance of RCA did not change significantly, but that of the LCA was diminished significantly (p less than 0.025) within the perfusion period indicating a delayed washout of calcium from the extracellular space. Myocardial O2 consumption was reduced from 2.71 ml/min (1. minute) to 1.51 ml/min (4. minute) to 0.93 ml/min (7. minute) although the temperature had reached a low level after 3 minutes. The difference between 4. to 7. minutes is significant (p less than 0.001). By our results it is concluded that in adult hearts high-volume cardioplegic perfusion at a flow rate of 1 ml/min X gm at a perfusion pressure of 40 to 50 mmHg should be performed for at least 6 to 7 minutes to achieve a sufficient intra-ischemic myocardial protection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aortic Valve / metabolism
  • Aortic Valve / surgery
  • Cardiomyopathy, Hypertrophic / metabolism
  • Cardiomyopathy, Hypertrophic / surgery
  • Coronary Vessels / physiopathology
  • Electrolytes / metabolism
  • Energy Metabolism*
  • Female
  • Heart Arrest, Induced* / methods
  • Heart Valve Diseases / metabolism
  • Heart Valve Diseases / surgery
  • Humans
  • Male
  • Middle Aged
  • Myocardium / metabolism*
  • Oxygen Consumption
  • Partial Pressure
  • Perfusion / methods
  • Time Factors
  • Vascular Resistance

Substances

  • Electrolytes