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Murine Isolated Heart Model of Myocardial Stunning Associated with Cardioplegic Arrest
Published on: August 6, 2015
Effect of retrograde warm continuous cardioplegia on right ventricular function
M LeBoutillier1, E A Grossi, B M Steinberg
1Department of Surgery, New York University Medical Center, NY 10016.
Circulation
|November 1, 1994
Summary
Retrograde warm continuous cardioplegia (RWCC) may impair right ventricular function recovery after cardiac surgery. This method showed significantly depressed RV function compared to retrograde cold multidose cardioplegia, warranting cautious use.
Area of Science:
- Cardiovascular Surgery
- Myocardial Preservation
- Ventricular Function
Background:
- Retrograde warm continuous cardioplegia (RWCC) is a proposed myocardial preservation technique.
- Limited data exist on RWCC's impact on right ventricular (RV) function.
- Prior studies suggest poor cardioplegia distribution to the RV and interventricular septum with retrograde methods.
Purpose of the Study:
- To assess the functional preservation of the right ventricle following retrograde warm continuous cardioplegia (RWCC).
- To compare RV functional recovery between RWCC and retrograde cold multidose cardioplegia (RCMC).
Main Methods:
- Mongrel dogs (n=14) underwent 90 minutes of aortic cross-clamping with either RWCC (n=7) or RCMC (n=7) after antegrade arrest.
- Left and right ventricular (LV, RV) pressure-volume relationships were measured using sonomicrometers and pressure transducers.
- Ventricular function was assessed before arrest and at 30 and 60 minutes post-unclamping.
Main Results:
- RWCC resulted in significantly depressed RV function recovery at 30 minutes post-reperfusion (41.03% +/- 7.49%) compared to RCMC (79.40% +/- 13.82%).
- At 60 minutes post-reperfusion, RV function remained lower with RWCC (48.05% +/- 9.72%) versus RCMC (61.95% +/- 8.70%).
- No significant difference in LV functional recovery was observed between RWCC and RCMC at either time point.
Conclusions:
- Retrograde warm continuous cardioplegia (RWCC) demonstrates a potential for RV functional impairment.
- RCMC appears to offer superior RV functional recovery compared to RWCC.
- Caution is advised when using RWCC, especially in patients with pre-existing RV hypertrophy.
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