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Ann Thorac Surg 1989;48:397-403
© 1989 The Society of Thoracic Surgeons

Articles

Asanguineous Reperfusion in a Canine Model of Cardiopulmonary Bypass and Controlled Postischemic Work

Ivan M. Rebeyka, MD, Gregory J. Wilson, MD*, Robert A. Axford-Gatley, MSc, Alexander D. Romaschin, PhD, Donald A.G. Mickle, MD

Departments of Surgery and Clinical Biochemistry, Toronto General Hospital and University of Toronto, and Research Institute and Departments of Surgery and Pathology, Hospital for Sick Children, Toronto, Ontario, Canada

Accepted for publication June 7, 1989.

* Address reprint requests to Dr Wilson, Cardiovascular Laboratory, Room CCRW 1-885, Toronto General Hospital, 101 College St, Toronto, Ontario, Canada M5G 2C4

This study was designed to test the hypothesis that asanguineous reperfusion with a standard crystalloid cardioplegic solution results in improved myocardial salvage after a period of global ischemia. Four groups of 6 dogs each were placed on cardiopulmonary bypass. Control group A (work only) performed two hours of controlled work by contracting against a saline-filled left intraventricular balloon. Control group B (ischemia only) underwent 45 minutes of global normothermic ischemia before simple blood reperfusion while supported on bypass. Groups C and D were subjected to ischemia and reperfusion as in group B, followed by controlled work stress as in group A. Group D, however, received 500 mL of St. Thomas' Hospital solution immediately before blood reperfusion. Morphological analysis showed no significant injury in groups A and B, whereas group C had 11.4% ± 2.4% necrosis of heart mass versus 2.5% ± 1.1% in group D (p < 0.001). Biochemical data from left ventricular biopsies showed no significant differences between groups B, C, and D. Functional analyses showed deterioration of diastolic compliance in group C (p < 0.05), although a significant difference in systolic functional indexes could not be detected. Myocardial protection and salvage was improved by initial reperfusion with an asanguineous cardioplegic solution versus reperfusion with blood alone.






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