Blood Cardioplegia Recovers Myocardial Viability after Simple Cold Immersion in Long-term Heart Preservation

Background & Aims : We studied the efficiency of blood cardioplegic (BCP) solution as a perfusate in a combined method for long-term heart preservation. Methods : Fourteen adult mongrel dogs' donor hearts were stored in a hypothermic (4°C) University of Wisconsin (UW) solution for 12 hours and divided into two groups by the type of coronary perfusates : 15°C BCP solution (n = 7), and 4°C UW solution (n = 7). High-energy phosphate components (phosphocreatine, β-adenosine triphosphate) and intracellular pH were measured by 31P-nuclear magnetic resonance spectroscopy. Creatine phospho-kinase activity and lactic acid value discharged from the coronary sinus during the period of coronary perfusion were also measured. Results : BCP perfusion after simple cold immersion provided significant restoration of phosphocreatine and β-adenosine triphosphate, and lower levels of creatine phosphokinase and lactic acid compared with the perfusion using the UW solution. On the other hand, water content was significantly increased after coronary perfusion using BCP solution. However, there were no significant differences in histological findings between hearts perfused by either perfusate. Conclusion : These results suggest that blood cardioplegic solution is preferable to the UW solution for coronary perfusion following simple cold immersion.