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Does cardioplegic arrest compromise long-term left ventricular function?

K V Arom, F L Grover, J K Trinkle

    The Annals of Thoracic Surgery
    |June 1, 1980
    PubMed
    Summary
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    Global ischemia from cold potassium cardioplegia during cardiopulmonary bypass caused mild, long-term depression of left ventricular function under volume overload. However, resting heart function remained unaffected up to 12 weeks post-procedure.

    Area of Science:

    • Cardiovascular Surgery
    • Cardiac Anesthesia
    • Cardiomyopathy Research

    Background:

    • Cardiopulmonary bypass (CPB) is a critical procedure in cardiac surgery.
    • Cold potassium cardioplegia is widely used to induce cardiac arrest during CPB.
    • The long-term effects of cardioplegic arrest on myocardial function require further investigation.

    Purpose of the Study:

    • To evaluate the chronic, long-term effects of global ischemia induced by cold potassium cardioplegia during CPB.
    • To assess the impact of 60 minutes of cardioplegic arrest on hemodynamic variables and left ventricular function.
    • To determine the recovery profile of cardiac function up to 12 weeks post-procedure.

    Main Methods:

    • A comparative study involving 15 dogs divided into a control group (thoracotomy and instrumentation) and an experimental group (CPB with 60 minutes cardioplegic arrest).

    Related Experiment Videos

  • Weekly hemodynamic and left ventricular studies were conducted for 12 weeks postoperatively.
  • Measurements were taken at rest and during acute volume overload (saline infusion).

    • Main Results:

    • At rest, the experimental group showed a higher heart rate (18%) and lower stroke volume (14%) compared to controls.
    • During volume overload, the experimental group exhibited significantly blunted increases in cardiac output and maximal rate of left ventricular pressure rise (p < 0.01).
    • Left ventricular function curves indicated mild depression in functional capacity and contractility up to 7 weeks postoperatively during volume overload.

    Conclusions:

    • One hour of cardioplegic cardiac arrest did not cause resting cardiac dysfunction.
    • Mild depression of left ventricular function was observed during acute volume overload up to 7 weeks after CPB.
    • These findings suggest a potential for long-term, albeit mild, functional impairment following cardioplegic arrest under stress.