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The Annals of Thoracic Surgery, Vol 39, 134-138, Copyright © 1985 by The Society of Thoracic Surgeons
YF Chen and YT Lin
The right atrium differs from the left ventricle in two respects during
cardioplegic arrest: a higher proportion of noncoronary collateral flow is
delivered to the right atrium, and the atrium is frequently excluded from
topical ice cooling because of its higher position relative to the left
ventricle. These factors result in early rewarming of atrial myocardium. To
the best of our knowledge, the surgical literature contains no reports on
whether blood cardioplegia can provide better atrial myocardial
preservation than electrolyte cardioplegia. Twenty consecutive patients who
underwent cardiac operations were randomly selected to receive blood
cardioplegia (Group 1) or electrolyte cardioplegia (Group 2). Hypothermia
was achieved by systemic cooling and continuous topical cooling with ice
slush. Stereological morphometric study of mitochondria was performed on 40
biopsy specimens taken from the right atrium prior to aortic cross-clamping
(preischemia) and at the end of ischemia. In Group 1, total aortic
cross-clamp time was 72.8 +/- 32.5 minutes. The mean mitochondrial surface
area before ischemia was 0.224 +/- 0.032 mu 2 and after ischemia, 0.336 +/-
0.032 mu 2, a 50.0% increase in mitochondrial size. In Group 2, total
aortic cross-clamp time was 69.7 +/- 30.9 minutes. The mean mitochondrial
surface area before ischemia was 0.205 +/- 0.025 mu 2 and after ischemia,
0.439 +/- 0.111 mu 2, an average increase in mitochondrial size of 114.2%.
There was no significant difference between the two groups in mitochondrial
size before ischemia. However, after ischemia the mean mitochondrial
surface areas were significantly different (p less than 0.05).(ABSTRACT
TRUNCATED AT 250 WORDS)
ARTICLES
Comparison of blood cardioplegia to electrolyte cardioplegia on the effectiveness of preservation of right atrial myocardium: mitochondrial morphometric study
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