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Ann Thorac Surg 1986;41:79-84
© 1986 The Society of Thoracic Surgeons

Articles

Ultrastructural Myocardial Preservation During Coronary Artery Surgery: A Controlled, Prospective, Randomized Study in Humans

Sergio V. Morán, M.D.*, Benedicto Chuaqui, M.D., Manuel J. Irarrázaval, M.D., Pablo Thomsen, M.D., Miguel Navarro, M.D., Jorge Urzúa, M.D., Gustavo Maturana, M.D.

From the Departments of Cardiovascular Disease and Pathology, Catholic University School of Medicine, Santiago, Chile

Accepted for publication February 27, 1985.

* Address reprint requests to Dr. Morán, Hospital Clínico de la Universidad Católica, Marcoleta 347, Santiago, Chile

Potassium cardioplegia was compared with normothermic, intermittent ischemic arrest in 30 patients undergoing multiple coronary artery bypass grafts. Group 1 comprised 15 patients in whom cold potassium cardioplegia with St. Thomas' Hospital solution was used. In Group 2 were 15 patients who underwent intermittent ischemic arrest during the construction of the distal anastomoses. Two myocardial transmural left ventricular biopsies were done in each patient.

There was no operative mortality. Electron microscopical examination showed normal myocardial ultrastructure in both groups. In particular, mitochondria were well preserved in all samples. The postoperative electrocardiogram demonstrated a new Q wave in 1 patient in Group 2 whose level of the myocardial isoenzyme of creatine phosphokinase (CPK-MB) was within the normal range. The peak CPK-MB release in Group 1 was 23.2 ± 20.1 IU and in Group 2, 19.9 ± 15.1 IU. This difference was not statistically significant. The mean period of anoxic arrest in Group 1 was 49.5 ± 15 minutes and in Group 2, 25.5 ± 8 minutes (p < 0.001). Total cardiopulmonary bypass time in Group 1 was 114.5 ± 20 minutes and in Group 2, 90.2 ± 16 minutes (p < 0.01). It is concluded that both techniques can preserve myocardial subcellular architecture during multiple coronary artery bypass grafting in patients with normal left ventricular function.




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E. Baudet, N. Laborde, X. Roques, A. Berty, C. Oca, and R. Le Menn
Ultrastructural study comparing the myocardial protective effects of four different infusates (Bretschneider's, St Thomas's, standard Ringer's and blood potassium solutions) in the human heart
Perfusion, October 1, 1989; 4(4): 275 - 282.
[Abstract] [PDF]


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