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Ann Thorac Surg 1985;39:218-222
© 1985 The Society of Thoracic Surgeons

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Articles

Interactions between Pharmacological Cardioplegia and Hypothermia for Intraoperative Myocardial Protection

From the Department of Cardiac Surgery, University of Rome, and the Department of Organ and System Pathophysiology, Istituto Superiore di Sanità, Rome, Italy

Accepted for publication June 4, 1984.

^* Address reprint requests to Dr. Mario Chiavarelli, Division of Cardiothoracic Surgery, Emory University Clinic, 1365 Clifton Rd NE, Atlanta, GA 30322

Cold cardioplegia is currently the method of choice for providing myocardial protection during open-heart surgical procedures. Two components of protection, perfusion cooling and pharmacological cardiac arrest, were investigated in the guinea pig heart-lung model. The effects of two cardioplegic solutions, the University of Alabama Hospital solution and the St. Thomas' Hospital solution, and a control perfusate were compared. The results confirmed the efficacy of hypothermia as a protective agent and the additional protection afforded by pharmacological cardioplegia. Infusion temperature critically influenced the cardioprotective action of the Alabama solution: Striking protection was afforded only under hypothermic conditions, whereas myocardial damage was exacerbated by the infusion at 37°C. The St. Thomas' Hospital solution provided substantial protection independent of infusion temperature. Thus, the safety margin of the Alabama solution was narrower than that of the St. Thomas' solution. It is suggested that the difference between the two cardioplegic solutions partially depends on their coronary vasoactivity, since the administration of the Alabama solution at 37°C increased coronary perfusion pressure. It would seem worthwhile to use a temperature-independent cardioplegic solution devoid of coronary vasoconstricting action.

This article has been cited by other articles:

				M. Chiavarelli, R. Chiavarelli, A. Macchiarelli, A. Carpi, and B. Marino Calcium Entry Blockers and Cardioplegia: Interaction Between Nifedipine, Potassium, and Hypothermia Ann. Thorac. Surg., May 1, 1986; 41(5): 535 - 541. [Abstract] [PDF]