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Ann Thorac Surg 1985;40:368-373
© 1985 The Society of Thoracic Surgeons

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Articles

Does Prostacyclin (PGI₂) Cardioplegic Infusion Improve Myocardial Protection after Ischemic Arrest?

From the Department of Surgery, University of California, San Francisco, San Francisco, CA.

^* Address reprint requests to Dr. Yee, Department of Surgery, University of California, San Francisco—M896, San Francisco, CA 94143

To determine whether prostacyclin (PGI₂) plays a beneficial role in the blood-perfused heart undergoing global ischemia, 20 isolated canine hearts were studied after sustaining one hour of cardioplegic arrest under moderate hypothermia (27°C to 28°C). Left ventricular function (peak systolic pressure, rate of rise of left ventricular pressure [dP/dt], and compliance change in left ventricular volume), myocardial edema, coronary blood flow, and oxygen content were measured during the preischemic period and at 15 and 30 minutes during reperfusion.

Results showed an improved hemodynamic recovery (peak systolic pressure, p = 0.018 at 30 minutes; dP/dt, p = 0.020 at 15 minutes) in the group of hearts treated with PGI₂ infusion compared with controls. There was no difference in ventricular compliance or myocardial edema between the two groups. This benefit was attributed to a significant increase in myocardial blood flow (p = 0.028 at 15 minutes) and oxygen delivery (p = 0.021 at 15 minutes) during the reperfusion period with PGI₂. These data suggest a potential clinical role for PGI₂ when applied to the globally ischemic heart in the improvement of myocardial resuscitation during the early reperfusion period.

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