The Annals of Thoracic Surgery, Vol 35, 367-371, Copyright © 1983 by The Society of Thoracic Surgeons
Should ventricular fibrillation be induced prior to the infusion of cardioplegic solution?
TA Salerno and MA Chiong
The present study evaluates the metabolic effects on the left ventricular
energy stores of a clinically used cardioplegic solution that was infused
into the ascending aorta of pigs while the heart was either fibrillating
(induced ventricular fibrillation) or in normal sinus rhythm prior to
aortic clamping. Fibrillating hearts had lower stores of glycogen in the
epicardium and endocardium compared with hearts in normal sinus rhythm.
There was no difference in the stores of creatine phosphate between the
hearts for both the epicardium and endocardium, but stores of adenosine
triphosphate (ATP) in both layers were lower in fibrillating hearts. These
results indicate that for ideal myocardial protection the cardioplegic
solution should be infused while the heart is beating under cardiopulmonary
bypass, and that ventricular fibrillation induced and maintained prior to
cross-clamping may cause myocardial damage.
