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The Annals of Thoracic Surgery, Vol 57, 391-396, Copyright © 1994 by The Society of Thoracic Surgeons
SA Elgebaly, SL Houser, AF el Kerm, K Doyle, C Gillies and K Dalecki
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 10(4) cells/g wet weight) and left (16 +/- 1 x
10(4) 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 acute 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.
ARTICLES
Evidence of cardiac inflammation after open heart operations
Department of Surgery, Hartford Hospital, CT 06115.
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