Related Experiment Videos
Comparison of three methods of myocardial protection
Insights
Investigating myocardial protection, this study compared ischemic arrest with two cardioplegia methods in dogs. Infusion cardioplegia using LK 352 significantly enhanced myocardial protection and functional recovery post-ischemia.
Area of Science:
- Cardiovascular Surgery
- Cardiothoracic Research
- Myocardial Protection Strategies
Background:
- Myocardial ischemia during cardiac surgery poses significant risks.
- Effective myocardial protection is crucial for post-operative cardiac function.
- Current methods include ischemic arrest and various cardioplegia solutions.
Purpose of the Study:
- To evaluate the efficacy of ischemic arrest versus two cardioplegia methods for myocardial protection.
- To assess the impact of different cardioplegia strategies on post-ischemic cardiac function.
- To compare biochemical and functional recovery parameters following cardiac arrest.
Main Methods:
- Canine model subjected to 90-minute aortic cross-clamping.
- Comparison of ischemic arrest, injection cardioplegia (Cardioplegin), and infusion cardioplegia (LK 352).
- Analysis of myocardial adenine nucleotides, creatine phosphate, glycogen, and hemodynamic parameters.
Main Results:
- LK 352 infusion cardioplegia provided a 3.4-fold increase in myocardial protection compared to ischemic arrest.
- Cardioplegin injection increased protection 1.8-fold; functional recovery was better than ischemic arrest.
- LK 352 infusion resulted in no post-arrest functional depression, indicating superior protection.
Conclusions:
- Infusion cardioplegia with LK 352 offers superior myocardial protection during ischemia compared to ischemic arrest and injection cardioplegia.
- LK 352 preserves cardiac function effectively, avoiding post-arrest depression.
- This study highlights the potential of LK 352 for enhanced outcomes in cardiac surgery.
Abstract:
Ischemic arrest (45 minutes), injection cardioplegia (2-3 ml/kg body weight within 1 minute) using Cardioplegin (magnesium-aspartate-procaine-sorbitol) according to Kirsch (90 minutes), and infusion cardioplegia (30 ml/kg body weight within 5 to 7 minutes) employing solution LK 352 (sodium-potassium-magnesium-aspartate-sorbitol) according to Bretschneider (90 minutes) were investigated in dogs in order to evaluate their efficacy of protection during myocardial ischemia and their effects on post-ischemic cardiac function. Parameters studied were myocardial tissue levels of adenine nucleotides, creatine phosphate, total creatine and glycogen as well as heart rate, systemic pressure, cardiac output, LVEDP, left ventricular pressure-volume-work, dp/dtmax, t-dp/dtmax, (dp/dtmax)/IP, and Vpm. According to biochemical data corrected for differences in myocardial temperature during arrest, myocardial protection during aortic cross-clamping at a core temperature of 30 degrees C was increased 1.8-fold by Cardioplegin and 3.4-fold by LK 352 administration respectively when compared to ischemic arrest. Functional recovery was poor after ischemic arrest and better after Cardiplegin arrest. Infusion cardioplegia with LK 352 did not result in a post-arrest depression of functional parameters.