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Cardioplegia in the presence or absence of calcium
Insights
Bretschneider
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Biomedical Engineering
Background:
- Myocardial ischemia during aortic occlusion poses a risk to heart recovery.
- Cardioplegic solutions are crucial for myocardial protection during cardiac surgery.
- Bretschneider's cardioplegic solution (HTP) is a widely used myocardial protection strategy.
Purpose of the Study:
- To evaluate the impact of Bretschneider's cardioplegic solution on postischemic heart recovery in dogs.
- To compare the efficacy of a calcium-free cardioplegic solution versus one with added calcium.
Main Methods:
- Ninety minutes of aortic occlusion was induced in canine models.
- Bretschneider's HTP cardioplegic solution was administered at 6°C.
- Two groups were studied: one receiving calcium-free HTP, the other HTP with 5 X 10(-5) M CaCl2.
- Coronary perfusion occurred at the start of ischemia and after 30 and 60 minutes.
Main Results:
- No significant difference in functional heart recovery was observed between the two groups.
- Plasma creatine kinase activity, a marker of myocardial injury, showed no significant difference.
- Both calcium-free and calcium-containing Bretschneider solutions provided comparable myocardial protection.
Conclusions:
- Bretschneider's cardioplegic solution HTP effectively protects the heart during ischemia, even in its calcium-free formulation.
- Low temperature, administration method, and solution composition contribute to myocardial protection.
- The addition of low-concentration calcium chloride did not significantly alter the protective effects.
Abstract:
The effect of the Bretschneider procedure of myocardial protection on the recovery of dog hearts in the postischemic phase after 90 min of aortic occlusion was studied. In one series of experiments, Bretschneider's calcium-free cardioplegic solution HTP was used; in a second series, 5 X 10(-5) M CaCl2 was added to this solution. The coronary system was perfused with cardioplegic solution (6 degrees C) for 6 min at the onset and for 1 min after 30 and 60 min of ischemic arrest. Functional recovery of the heart and plasma creatine kinase activity during the postischemic phase were not significantly different in the two groups of dogs. It is concluded that low temperature, mode of administration, and composition of Bretschneider's cardioplegic solution HTP protect the heart against the potential danger of exposure to a calcium-free solution.