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Ann Thorac Surg 1992;53:455-459
© 1992 The Society of Thoracic Surgeons

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Articles

Effects of cardioplegic solutions and their components on human saphenous vein contractility

Department of Cardiovascular Surgery, University of Rome "La Sapienza", and Department of Pharmacology, Istituto Superiore di Sanita, Rome, Italy

Accepted for publication August 27, 1991.

^_* Address reprint requests to Dr Chiavarelli, Division of Cardiothoracic Surgery, Loma Linda University Medical Center, 11234 Anderson St, Loma Linda, CA 92354 USA.

Cardioplegic solution administration into the vein graft is an established method to ensure cardioplegic distribution beyond coronary artery stenoses. The ultrastructural demonstration of severe endothelial damage after cardioplegic exposure suggests that intravenous cardioplegic administration can contribute to early and late graft thrombosis. The direct effect on human saphenous vein contractility of three cardioplegic solutions and their components was compared. A solution with 30 mmol/L K⁺ and 82 mmol/L Na⁺ produced intense venoconstriction. Lowering the potassium level to 10 mmol/L and increasing the sodium level to 92 mmol/L reduced its vasoconstricting action. A third solution with 16 mmol/L K⁺, 16 mmol/L Mg²⁺, and lidocaine caused venodilatation. Analysis of the single component effects showed that high potassium level, low sodium level, and the addition of lidocaine produced concentration-dependent vasoconstriction. High magnesium concentration resulted in vasodilatation. The present data suggest that cardioplegic solution composition may cause marked vasomotor effects on saphenous vein and thus influence its endothelial integrity. In the search for an "ideal solution" to the cardioplegic controversy, a venoconstrictor infusate should be avoided to improve patency rates of coronary artery bypass grafts.

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