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Ann Thorac Surg 1990;50:230-237
© 1990 The Society of Thoracic Surgeons

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Articles

Preservation of myocardial function and biochemistry after blood and oxygenated crystalloid cardioplegia during cardiac arrest

Departments of Anesthesiology, Cardiothoracic Surgery, and Physiology and Biochemistry, MRC Centre for Molecular and Cellular Cardiology, University of Stellenbosch Medical School, Tygerberg, South Africa

Accepted for publication February 22, 1990.

^_* Address reprint requests to Prof Coetzee, Department of Anesthesiology, University of Stellenbosch Medical School, PO Box 63, Tygerberg 7505 South Africa.

We compared the ability of blood cardioplegia and oxygenated crystalloid cardioplegic solutions to maintain regional left ventricle contractility and adenosine triphosphate levels after cardiopulmonary bypass. Ten baboons were subjected to 90-minute cardiopulmonary bypass conducted at 28 °C. Hemodynamic measurements were made before and after the bypass procedure, and biopsies for high-energy phosphate determinations were performed at different time intervals during and after bypass. The results showed improved maintenance of myocardial contractility (measured with the regional end-systolic pressure-length relationship) with the oxygenated crystalloid solution. Expressed as a percentage of values before bypass, contractility after bypass averaged 81.69% ± 4.81% and 80.47% ± 10.05%, respectively, after 10 and 20 minutes using the oxygenated crystalloid cardioplegia. For blood cardioplegia, the corresponding values were 71.9% ± 8.73% and 64.99% ± 8.60% (mean ± standard error of the mean). The 10- and 20-minute postbypass values between the two groups differed significantly (t test, Welch modification: p = 0.0464 and p = 0.0342). Myocardial adenosine triphosphate level was higher immediately after induction of cardiac arrest when blood cardioplegia was used (blood cardioplegia, 6.82 mol · g wet wt^–1; crystalloid cardioplegia, 4.95 mol · g wet wt^–1; p = 0.0314), but values subsequently equalized.

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