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Ann Thorac Surg 1994;57:391-396
© 1994 The Society of Thoracic Surgeons


Articles

Evidence of cardiac inflammation after open heart operations

Salwa A. Elgebaly, PhD*,a,b,c, Stuart L. Houser, MDa,b,c, Ashraf F. El Kerm, MDa,b,c, Kathleen Doyle, CCPa,b,c, Concettina Gillies, MSa,b,c, Karen Dalecki, BSca,b,c

a Surgical Research Center, Department of Surgery, Hartford Hospital Farmington, Connecticut, USA
b Surgical Research Center, Department of Surgery, University of Connecticut School of Medicine, Farmington, Connecticut, USA
c Department of Pathology, University of Connecticut School of Medicine, Farmington, Connecticut, USA

Accepted for publication March 31, 1993.

* Address reprint requests to Dr Elgebaly, Surgical Research Center, Department of Surgery, Hartford Hospital, Hartford, CT 06115.

In this study, 6 anesthetized dogs underwent global cardiac arrest for 1 hour, followed by reperfusion on bypass for 45 minutes. The hearts were then weaned off cardiopulmonary bypass and monitored for an additional 2 hours. Using modified Boyden chambers, high levels of neutrophil chemotactic activity were detected (using a checkerboard analysis) in the coronary sinus effluents obtained during cardiac arrest. The activity tended to decline during reperfusion. Assay of myeloperoxidase (a marker for neutrophils) revealed an accumulation of large numbers of neutrophils in the right (14 ± 1.1 x 104 cells/g wet weight) and left (16 ± 1 x 104 cells/g wet weight) ventricles after 2 hours of reperfusion. Light microscopy evaluation confirmed the presence of neutrophils, not only in the ventricles, but also in a greater number in the right and left atria. Electron microscopy study of these hearts revealed the presence of mild reversible changes, indicating good preservation of the hearts during arrest. Results of this study provide evidence for an acate inflammatory reaction that takes place after cardiac operations and suggest a role for myocardial tissues in the initiation of such a response through their release of neutrophil chemotactic factors.




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