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Ann Thorac Surg 1999;67:1623-1629
© 1999 The Society of Thoracic Surgeons

Original Articles

Pretreatment with a potassium-channel opener before prolonged cardiac storage: an evaluation in an experimental brain death model

Matthias Kirsch, MDa, Sylvie Bertrand, MDa, Jean-Paul Garnier, MDb, Christine Fernandez, PharmDa, Christophe Baufreton, MD, PhDa, Alain Astier, PharmDa, Daniel Loisance, MDa

a Centre de Recherches Chirurgicales Henri Mondor and the Pharmacie Centrale, Hôpital Henri Mondor, Créteil, France
b Department of Biochemistry, Hôpital Saint-Louis, Paris, France

Accepted for publication November 13, 1998.

Address reprint requests to Dr Loisance, Centre de Recherches Chirurgicales Henri Mondor, Faculté de Médecine, 8 rue du Générail Sarrail, 94010 Créteil Cédex, France

Background. Pretreatment with a potassium-channel opener has been shown to improve functional recovery after long-term cardioplegic arrest. We evaluated whether pretreatment with the potassium-channel opener cromakalim is beneficial in a more clinically relevant experimental model of brain death in the rabbit.

Methods. Four groups of rabbits were studied in a 2 x 2 factorial experiment (n = 8 per group). Rabbits were subjected to a sham operation or 90 minutes of brain death induced by inflating a subdurally placed balloon. Thirty minutes before heart explantation, rabbits received either no pretreatment or an intravenous injection of cromakalim, 30 µg/kg. Hearts then received 5 hours’ hypothermic storage in St. Thomas’ Hospital solution and were assessed on a buffer-perfused isolated heart preparation. Hemodynamic recovery, coronary flow, and creatine kinase release were determined after 60 minutes of reperfusion.

Results. Systolic function and diastolic function were significantly altered in hearts explanted from brain-dead rabbits compared with hearts from rabbits having a sham operation. Cromakalim pretreatment had no significant effect on poststorage systolic or diastolic function of hearts explanted from brain-dead or sham-operation rabbits. Further, cromakalim pretreatment did not affect coronary flow or overall creatine kinase release during reperfusion.

Conclusions. In vivo pretreatment of brain-dead rabbits or anesthetized rabbits with an intravenous injection of cromakalim had no significant effect on functional recovery of or enzymatic release from explanted hearts after 5 hours’ hypothermic storage and 60 minutes’ reperfusion. These findings underscore the importance of clinically relevant experimental models.


Related Article

Manuel Galiñanes
Ann. Thorac. Surg. 1999 67: 1630. [Extract] [Full Text] [PDF]





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