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Ann Thorac Surg 1982;33:116-122
© 1982 The Society of Thoracic Surgeons

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Articles

The Effects of Global Ischemia and Reperfusion on Human Myocardium: Quantitative Evaluation by Electron Microscopic Morphometry

From the Max-Planck-Institut für physiologische und klinische Forschung, Abt. Experimentelle Kardiologie, Bad Nauheim, the Medizinische Poliklinik, Giessen, and Zentrum für Chirurgie, am Klinikum der Justus-Liebig-Universität, Giessen, West Germany

Accepted for publication April 8, 1981.

^* Address reprint requests to Dr. Schaper, Max-Planck-Institut für physiologische und klinische Forschung, Abt. Experimentelle Kardiologie, D-6350 Bad Nauheim, West Germany

During open-heart operation, myocardial biopsies were taken from 31 patients undergoing aortic valve replacement during total cardiopulmonary bypass. The first needle biopsy was taken before induction of cardiac arrest (Kirsch cardioplegia), the second at the end of global ischemia, and the third during the reperfusion period. The tissue was investigated by electron microscopy, in both a qualitative and a quantitative manner (morphometry). Ultrastrucrural morphometry revealed cellular and especially mitochondrial swelling that occurred during the reperfusion phase, but not after ischemia alone. On the basis of morphological measurements, this study shows the occurrence of postishemic cellular and mitochondrial edema that possibly might be avoided by the use of improved techniques of myocardial protection during operation.

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