Effects of Varied Cardioplegic Perfusion Pressure on Myocardial Preservation with Critical Coronary Stenosis

Mark D. Avery, Jose Ybarra, Robert Estrello, Susan Norris, John J. Ghidoni, John Mack, J. Kent Trinkle, Frederick L. Grover

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Inadequate delivery of cardioplegic solution distal to coronary artery stenosis may result in increased injury during ischemic arrest. This study was performed to determine the effects of cardioplegic perfusion pressure on cardioplegia delivery and myocardial preservation in hearts with critical coronary artery stenosis. Twenty dogs underwent 90 minutes of cold potassium cardioplegic arrest with partial occlusion of the circumflex coronary artery. Group 1 received cardioplegia at 50 mm Hg pressure, Group 2 at 90 mm Hg pressure, and Group 3 at 130 mm Hg pressure. It was found that cooling rates were 5.4°, 9.1°, and 18.2°C per minute in the nonischemic area (p = 0.004) and 2.0°, 4.5°, and 7.9°C in the ischemic area (p = 0.008) in Groups 1, 2, and 3, respectively. Total of cardioplegic solution flows were 86, 188, and 262 ml per minute per 100 gm in Groups 1, 2, and 3, respectively (p = 0.001). However, flow did not differ significantly between groups in the ischemic area. Rate of rise of left ventricular (LV) pressure decreased significantly in Groups 1 and 2 but not in Group 3 (p = 0.002). Other measured variables did not differ significantly between groups, although LV function curves showed less deterioration in the high-pressure groups. It is concluded that higher cardioplegic perfusion pressure resulted in more rapid cooling in normal and ischemic areas and slightly better preservation of ventricular function as measured by some indexes. However, preservation was generally good for each of the pressures for up to 90 minutes of ischemia when the septum was consistently cooled to 10°C.

Original languageEnglish (US)
Pages (from-to)469-474
Number of pages6
JournalAnnals of Thoracic Surgery
Volume40
Issue number5
DOIs
StatePublished - Jan 1 1985

Fingerprint

Coronary Stenosis
Perfusion
Pressure
Cardioplegic Solutions
Induced Heart Arrest
Ventricular Function
Ventricular Pressure
Left Ventricular Function
Coronary Vessels
Potassium
Ischemia
Dogs
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Effects of Varied Cardioplegic Perfusion Pressure on Myocardial Preservation with Critical Coronary Stenosis. / Avery, Mark D.; Ybarra, Jose; Estrello, Robert; Norris, Susan; Ghidoni, John J.; Mack, John; Trinkle, J. Kent; Grover, Frederick L.

In: Annals of Thoracic Surgery, Vol. 40, No. 5, 01.01.1985, p. 469-474.

Research output: Contribution to journalArticle

Avery, Mark D. ; Ybarra, Jose ; Estrello, Robert ; Norris, Susan ; Ghidoni, John J. ; Mack, John ; Trinkle, J. Kent ; Grover, Frederick L. / Effects of Varied Cardioplegic Perfusion Pressure on Myocardial Preservation with Critical Coronary Stenosis. In: Annals of Thoracic Surgery. 1985 ; Vol. 40, No. 5. pp. 469-474.
@article{053ddcdca25d4cbd918a6a72867dec7b,
title = "Effects of Varied Cardioplegic Perfusion Pressure on Myocardial Preservation with Critical Coronary Stenosis",
abstract = "Inadequate delivery of cardioplegic solution distal to coronary artery stenosis may result in increased injury during ischemic arrest. This study was performed to determine the effects of cardioplegic perfusion pressure on cardioplegia delivery and myocardial preservation in hearts with critical coronary artery stenosis. Twenty dogs underwent 90 minutes of cold potassium cardioplegic arrest with partial occlusion of the circumflex coronary artery. Group 1 received cardioplegia at 50 mm Hg pressure, Group 2 at 90 mm Hg pressure, and Group 3 at 130 mm Hg pressure. It was found that cooling rates were 5.4°, 9.1°, and 18.2°C per minute in the nonischemic area (p = 0.004) and 2.0°, 4.5°, and 7.9°C in the ischemic area (p = 0.008) in Groups 1, 2, and 3, respectively. Total of cardioplegic solution flows were 86, 188, and 262 ml per minute per 100 gm in Groups 1, 2, and 3, respectively (p = 0.001). However, flow did not differ significantly between groups in the ischemic area. Rate of rise of left ventricular (LV) pressure decreased significantly in Groups 1 and 2 but not in Group 3 (p = 0.002). Other measured variables did not differ significantly between groups, although LV function curves showed less deterioration in the high-pressure groups. It is concluded that higher cardioplegic perfusion pressure resulted in more rapid cooling in normal and ischemic areas and slightly better preservation of ventricular function as measured by some indexes. However, preservation was generally good for each of the pressures for up to 90 minutes of ischemia when the septum was consistently cooled to 10°C.",
author = "Avery, {Mark D.} and Jose Ybarra and Robert Estrello and Susan Norris and Ghidoni, {John J.} and John Mack and Trinkle, {J. Kent} and Grover, {Frederick L.}",
year = "1985",
month = "1",
day = "1",
doi = "10.1016/S0003-4975(10)60102-6",
language = "English (US)",
volume = "40",
pages = "469--474",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "5",

}

TY - JOUR

T1 - Effects of Varied Cardioplegic Perfusion Pressure on Myocardial Preservation with Critical Coronary Stenosis

AU - Avery, Mark D.

AU - Ybarra, Jose

AU - Estrello, Robert

AU - Norris, Susan

AU - Ghidoni, John J.

AU - Mack, John

AU - Trinkle, J. Kent

AU - Grover, Frederick L.

PY - 1985/1/1

Y1 - 1985/1/1

N2 - Inadequate delivery of cardioplegic solution distal to coronary artery stenosis may result in increased injury during ischemic arrest. This study was performed to determine the effects of cardioplegic perfusion pressure on cardioplegia delivery and myocardial preservation in hearts with critical coronary artery stenosis. Twenty dogs underwent 90 minutes of cold potassium cardioplegic arrest with partial occlusion of the circumflex coronary artery. Group 1 received cardioplegia at 50 mm Hg pressure, Group 2 at 90 mm Hg pressure, and Group 3 at 130 mm Hg pressure. It was found that cooling rates were 5.4°, 9.1°, and 18.2°C per minute in the nonischemic area (p = 0.004) and 2.0°, 4.5°, and 7.9°C in the ischemic area (p = 0.008) in Groups 1, 2, and 3, respectively. Total of cardioplegic solution flows were 86, 188, and 262 ml per minute per 100 gm in Groups 1, 2, and 3, respectively (p = 0.001). However, flow did not differ significantly between groups in the ischemic area. Rate of rise of left ventricular (LV) pressure decreased significantly in Groups 1 and 2 but not in Group 3 (p = 0.002). Other measured variables did not differ significantly between groups, although LV function curves showed less deterioration in the high-pressure groups. It is concluded that higher cardioplegic perfusion pressure resulted in more rapid cooling in normal and ischemic areas and slightly better preservation of ventricular function as measured by some indexes. However, preservation was generally good for each of the pressures for up to 90 minutes of ischemia when the septum was consistently cooled to 10°C.

AB - Inadequate delivery of cardioplegic solution distal to coronary artery stenosis may result in increased injury during ischemic arrest. This study was performed to determine the effects of cardioplegic perfusion pressure on cardioplegia delivery and myocardial preservation in hearts with critical coronary artery stenosis. Twenty dogs underwent 90 minutes of cold potassium cardioplegic arrest with partial occlusion of the circumflex coronary artery. Group 1 received cardioplegia at 50 mm Hg pressure, Group 2 at 90 mm Hg pressure, and Group 3 at 130 mm Hg pressure. It was found that cooling rates were 5.4°, 9.1°, and 18.2°C per minute in the nonischemic area (p = 0.004) and 2.0°, 4.5°, and 7.9°C in the ischemic area (p = 0.008) in Groups 1, 2, and 3, respectively. Total of cardioplegic solution flows were 86, 188, and 262 ml per minute per 100 gm in Groups 1, 2, and 3, respectively (p = 0.001). However, flow did not differ significantly between groups in the ischemic area. Rate of rise of left ventricular (LV) pressure decreased significantly in Groups 1 and 2 but not in Group 3 (p = 0.002). Other measured variables did not differ significantly between groups, although LV function curves showed less deterioration in the high-pressure groups. It is concluded that higher cardioplegic perfusion pressure resulted in more rapid cooling in normal and ischemic areas and slightly better preservation of ventricular function as measured by some indexes. However, preservation was generally good for each of the pressures for up to 90 minutes of ischemia when the septum was consistently cooled to 10°C.

UR - http://www.scopus.com/inward/record.url?scp=0022410078&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0022410078&partnerID=8YFLogxK

U2 - 10.1016/S0003-4975(10)60102-6

DO - 10.1016/S0003-4975(10)60102-6

M3 - Article

C2 - 4062399

AN - SCOPUS:0022410078

VL - 40

SP - 469

EP - 474

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 5

ER -