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Ann Thorac Surg 1988;46:406-411
© 1988 The Society of Thoracic Surgeons
Baker Medical Research Institute, Melbourne, Australia
Accepted for publication April 18, 1988.
* Address reprint requests to Dr. Rosenfeldt, Baker Medical Research Institute, PO Box 348, Commercial Rd, Prahran, Victoria, Australia 3181
This study was designed to determine if the improved hypothermia that can be achieved with cold perfusion of the right atrium is associated with improved atrial preservation. During 120 minutes of cardioplegic arrest, 7 dogs with occlusive caval cannulation underwent right atrial (RA) perfusion with cold blood and 7 dogs with a single atriocaval cannula served as controls. RA perfusion produced a lower atrial septal temperature than atriocaval cannulation, 96% less electrical activity during arrest, and a lesser prolongation of the A-H interval after reperfusion (40% versus 123%; p > 0.01). At the end of arrest, compared with atriocaval cannulation, RA perfusion was associated with improved preservation of creatine phosphate (71 ± 10% versus 40 ± 7% of control; p > 0.05) and a lower level of lactate in the RA wall (8 ± 1 µmol/gm versus 15 ± 2 µmol/gm; p > 0.01). We conclude that improved hypothermia reduces electrical activity and anaerobic metabolism in the atrial myocardium during cardioplegic arrest and improves atrioventricular conduction following arrest.
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