Perfluorocarbon supplementation and postischemic cardiac function

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Perfluorocarbon Applications

Background:

• Inefficient anaerobic metabolism occurs during induced ischemia in cardiac surgery.
• Sustaining aerobic metabolism via perfluorocarbon-supplemented blood cardioplegia may improve postischemic recovery.
• Perflubron (C8F17Br) is a lecithin-emulsified perfluorocarbon with a shorter half-life.

Purpose of the Study:

• To compare the efficacy of perflubron-supplemented blood cardioplegia versus standard blood cardioplegia in preserving myocardial function after ischemia.
• To evaluate the impact of perfluorocarbons on aerobic metabolism and postischemic recovery in the heart.

Main Methods:

• Nineteen dogs underwent 15 minutes of global ischemia at 37°C on cardiopulmonary bypass.
• Cardioplegic arrest was induced using blood cardioplegia with or without perflubron, followed by 30 minutes of reperfusion.
• Myocardial oxygen tension, pH, preload recruitable stroke work, and energy charge were measured to assess ventricular recovery.

Main Results:

• Perflubron supplementation significantly increased the recovery of preload recruitable stroke work slope (71% ± 8% vs. 42% ± 9%).
• Reduced myocardial edema and enhanced end-ischemic myocardial oxygen and pH levels were observed with perflubron.
• Perflubron-supplemented cardioplegia demonstrated superior myocardial protection compared to standard blood cardioplegia.

Conclusions:

• Perfluorocarbons, like perflubron, offer a reliable oxygen delivery system and endothelial-preserving properties.
• Perfluorocarbon-enriched blood cardioplegia is a valuable addition to standard methods for preserving postischemic ventricular function.
• Further investigation into perfluorocarbon-enriched blood cardioplegia for cardiac surgery is warranted.