HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Arun K. Singh Karl E. Karlson Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Singh, A. K. Articles by Karlson, K. E. Search for Related Content PubMed PubMed Citation Articles by Singh, A. K. Articles by Karlson, K. E.

Ann Thorac Surg 1982;33:218-227
© 1982 The Society of Thoracic Surgeons

---

Articles

Electrolyte versus Blood Cardioplegia: Randomized Clinical and Myocardial Ultrastructural Study

From the Departments of Surgery and Pathology, Rhode Island Hospital, and the Division of Biology and Medicine, Brown University, Providence, RI

Accepted for publication April 14, 1981.

^* Address reprint requests to Dr. Singh, 110 Lockwood St, Providence, RI 02903

In 40 consecutive patients undergoing coronary artery bypass, one of two solutions for cardioplegia, each containing 30 mEq/L of K⁺ was used randomly. The groups were comparable except for intramyocardial temperature. With electrolyte solution (Group A), it was 16.5° ± 0.34°C, while with blood from the pump-oxygenator (Group B) it was 20.3° ± 0.41°C (p < 0.001). After bypass left atrial pressure (LAP) was 11.9 ± 0.67 torr in Group A and 8.1 ± 0.49 torr in Group B (p < 0.001). CPK-MB was elevated in 45% of Group A patients versus 15% in Group B (p < 0.05). No patient died. Two myocardial infarctions occurred in Group A and one in Group B. Stereological morphometric electron microscopy was performed on biopsy specimens taken from the left ventricle (1) before perfusion, (2) after cardioplegia, and (3) 30 minutes after reperfusion. Group A showed marked intracellular edema, mitochondrial swelling, pronounced depletion of glycogen stores, and focal myofibrillary disorganization. Group B showed near normal myocardial ultrastructure with increased glycogen stores and minimal mitochondrial swelling. Morphometric analysis revealed a statistically significant increase in the degree of mitochondrial swelling (51%) in Group A compared with Group B after reperfusion (p < 0.001). Thus, blood K⁺ cardioplegia resulted in better preservation of myocardial ultrastructure, lower ventricular filling pressure, and lesser CPK-MB release compared with this particular electrolyte cardioplegia.

This article has been cited by other articles:

				V. Guru, J. Omura, A. A. Alghamdi, R. Weisel, and S. E. Fremes Is Blood Superior to Crystalloid Cardioplegia?: A Meta-Analysis of Randomized Clinical Trials Circulation, July 4, 2006; 114(1_suppl): I-331 - I-338. [Abstract] [Full Text] [PDF]

				S. Mizutani, A. S. Al-Dadah, J. B. Bloch, S. M. Prasad, M. D. Diodato, R. B. Schuessler, R. J. Damiano Jr, and J. S. Lawton Hyperkalemic Cardioplegia-Induced Myocyte Swelling and Contractile Dysfunction: Prevention by Diazoxide Ann. Thorac. Surg., January 1, 2006; 81(1): 154 - 159. [Abstract] [Full Text] [PDF]

				I. G. Duarte, S. T. Shearer, M. J. MacDonald, J. P. Gott, W. M. Brown III, J. Vinten-Johansen, and R. A. Guyton Myocardial Distribution of Antegrade Cold Crystalloid and Tepid Blood Cardioplegia Ann. Thorac. Surg., June 1, 1998; 65(6): 1610 - 1616. [Abstract] [Full Text] [PDF]

				W. M. L. Neethling, J. J. van den Heever, S. Cooper, and J. M. Meyer Interstitial pH during myocardial preservation: Assessment of five methods of myocardial preservation Ann. Thorac. Surg., February 1, 1993; 55(2): 420 - 426. [Abstract] [PDF]

				H. B. Barner Blood cardioplegia: A review and comparison with crystalloid cardioplegia Ann. Thorac. Surg., December 1, 1991; 52(6): 1354 - 1367. [Abstract] [PDF]

				A. Coetzee, G. Roussouw, P. Fourie, and A. Lochner Preservation of myocardial function and biochemistry after blood and oxygenated crystalloid cardioplegia during cardiac arrest Ann. Thorac. Surg., August 1, 1990; 50(2): 230 - 237. [Abstract] [PDF]

				K. H. Teoh, G. T. Christakis, R. D. Weisel, C. P. Tong, L. L. Mickleborough, H. E. Scully, B. S. Goldman, and R. J. Baird The Determinants of Mortality and Morbidity after Multiple-Valve Operations Ann. Thorac. Surg., April 1, 1987; 43(4): 353 - 358. [Abstract] [PDF]

				S. V. Moran, B. Chuaqui, M. J. Irarrazaval, P. Thomsen, M. Navarro, J. Urzua, and G. Maturana Ultrastructural Myocardial Preservation During Coronary Artery Surgery: A Controlled, Prospective, Randomized Study in Humans Ann. Thorac. Surg., January 1, 1986; 41(1): 79 - 84. [Abstract] [PDF]

				A. J. Roberts, D. D. Woodhall, D. G. Knauf, and J. A. Alexander Coronary Artery Bypass Graft Surgery: Clinical Comparison of Cold Blood Potassium Cardioplegia, Warm Cardioplegic Induction, and Secondary Cardioplegia Ann. Thorac. Surg., November 1, 1985; 40(5): 483 - 487. [Abstract] [PDF]

				J. E. Codd, H. B. Barner, D. G. Pennington, J. P. Merjavy, G. C. Kaiser, J. E. Devine, and V. L. Willman Intraoperative Myocardial Protection: A Comparison of Blood and Asanguineous Cardioplegia Ann. Thorac. Surg., February 1, 1985; 39(2): 125 - 133. [Abstract] [PDF]

				Y.-F. Chen and Y.-T. Lin Comparison of Blood Cardioplegia to Electrolyte Cardioplegia on the Effectiveness of Preservation of Right Atrial Myocardium: Mitochondrial Morphometric Study Ann. Thorac. Surg., February 1, 1985; 39(2): 134 - 138. [Abstract] [PDF]

				V. R. Conti and R. L. Kao Metabolic and Functional Effects of Carbohydrate Substrate with Single-Dose and Multiple-Dose Potassium Cardioplegia Ann. Thorac. Surg., September 1, 1983; 36(3): 320 - 327. [Abstract] [PDF]

				G. F. O. Tyers Cardioplegia Techniques Ann. Thorac. Surg., June 1, 1983; 35(6): 687 - 687. [PDF]