Enhanced Functional Recovery with Venting during Cardioplegic Arrest in Chronically Damaged Hearts
Thirty dogs with experimental myocardial infarction underwent cardiopulmonary bypass, hypothermic asanguineous K + cardioplegia (1 hour), and reperfusion (30 minutes). Ten hearts were vented throughout, 5 only during arrest, and 5 only during reperfusion; 10 were not vented. Left ventricular (LV) pe...
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| Veröffentlicht in: | The Annals of thoracic surgery 1985-12, Vol.40 (6), p.566-573 |
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| creator | Mills, Stephen A. Hansen, Kimberley Vinten-Johansen, J. Howe, Harold R. Geisinger, Kim R. Cordell, A. Robert |
| description | Thirty dogs with experimental myocardial infarction underwent cardiopulmonary bypass, hypothermic asanguineous K
+ cardioplegia (1 hour), and reperfusion (30 minutes). Ten hearts were vented throughout, 5 only during arrest, and 5 only during reperfusion; 10 were not vented. Left ventricular (LV) performance and compliance were assessed by isovolumic (LV balloon) indexes before bypass and after reperfusion. Vented hearts recovered 116 ± 8.3% of prearrest developed LV systolic pressure (DLVSP) and 131 ± 13.6% of prearrest rate of rise of LV pressure (dP/dt). Nonvented hearts allowed to develop pressure during arrest (11.6 ± 1.6 mm Hg) and reperfusion (65 ± 4 mm Hg) recovered 50 ± 3.9% of prearrest DLVSP and 55 ± 5% of prearrest dP/dt (
p < 0.05). Reduction in LV compliance was comparable in both groups. Mitochondrial architecture (electron microscopy) was preserved in vented hearts, but was modestly disrupted in nonvented hearts, thus suggesting slight metabolic impairment. Functional recovery was nearly complete in hearts vented only during reperfusion (DLVSP, 94 ± 10.4%; dP/dt, 89 ± 12.6%), but venting only during arrest led to functional depression (DLVSP, 50 ± 6.6%;dP/dt, 51 ± 8%;
p = 0.01). We conclude that venting chronically infarcted hearts during cardiac operations affords better myocardial protection by avoiding the damage that occurs during nonvented reperfusion. |
| doi_str_mv | 10.1016/S0003-4975(10)60350-5 |
| format | Article |
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+ cardioplegia (1 hour), and reperfusion (30 minutes). Ten hearts were vented throughout, 5 only during arrest, and 5 only during reperfusion; 10 were not vented. Left ventricular (LV) performance and compliance were assessed by isovolumic (LV balloon) indexes before bypass and after reperfusion. Vented hearts recovered 116 ± 8.3% of prearrest developed LV systolic pressure (DLVSP) and 131 ± 13.6% of prearrest rate of rise of LV pressure (dP/dt). Nonvented hearts allowed to develop pressure during arrest (11.6 ± 1.6 mm Hg) and reperfusion (65 ± 4 mm Hg) recovered 50 ± 3.9% of prearrest DLVSP and 55 ± 5% of prearrest dP/dt (
p < 0.05). Reduction in LV compliance was comparable in both groups. Mitochondrial architecture (electron microscopy) was preserved in vented hearts, but was modestly disrupted in nonvented hearts, thus suggesting slight metabolic impairment. Functional recovery was nearly complete in hearts vented only during reperfusion (DLVSP, 94 ± 10.4%; dP/dt, 89 ± 12.6%), but venting only during arrest led to functional depression (DLVSP, 50 ± 6.6%;dP/dt, 51 ± 8%;
p = 0.01). We conclude that venting chronically infarcted hearts during cardiac operations affords better myocardial protection by avoiding the damage that occurs during nonvented reperfusion.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/S0003-4975(10)60350-5</identifier><identifier>PMID: 4074005</identifier><identifier>CODEN: ATHSAK</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Anesthesia ; Anesthesia depending on type of surgery ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Animals ; Biological and medical sciences ; Cardiac Catheterization ; Cardiopulmonary Bypass ; Dogs ; Drainage ; Heart - physiopathology ; Heart Arrest, Induced ; Heart Ventricles ; Intraoperative Care ; Medical sciences ; Microscopy, Electron ; Myocardial Infarction - pathology ; Myocardial Infarction - physiopathology ; Myocardial Infarction - therapy ; Myocardium - pathology ; Pressure ; Thoracic and cardiovascular surgery. Cardiopulmonary bypass ; Time Factors</subject><ispartof>The Annals of thoracic surgery, 1985-12, Vol.40 (6), p.566-573</ispartof><rights>1985 The Society of Thoracic Surgeons</rights><rights>1986 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-7764484f39621df89e6bd38fdbaf4e4a4b0043d08060ebefa5bdedd9786c870b3</citedby><cites>FETCH-LOGICAL-c424t-7764484f39621df89e6bd38fdbaf4e4a4b0043d08060ebefa5bdedd9786c870b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=8488365$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/4074005$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mills, Stephen A.</creatorcontrib><creatorcontrib>Hansen, Kimberley</creatorcontrib><creatorcontrib>Vinten-Johansen, J.</creatorcontrib><creatorcontrib>Howe, Harold R.</creatorcontrib><creatorcontrib>Geisinger, Kim R.</creatorcontrib><creatorcontrib>Cordell, A. Robert</creatorcontrib><title>Enhanced Functional Recovery with Venting during Cardioplegic Arrest in Chronically Damaged Hearts</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>Thirty dogs with experimental myocardial infarction underwent cardiopulmonary bypass, hypothermic asanguineous K
+ cardioplegia (1 hour), and reperfusion (30 minutes). Ten hearts were vented throughout, 5 only during arrest, and 5 only during reperfusion; 10 were not vented. Left ventricular (LV) performance and compliance were assessed by isovolumic (LV balloon) indexes before bypass and after reperfusion. Vented hearts recovered 116 ± 8.3% of prearrest developed LV systolic pressure (DLVSP) and 131 ± 13.6% of prearrest rate of rise of LV pressure (dP/dt). Nonvented hearts allowed to develop pressure during arrest (11.6 ± 1.6 mm Hg) and reperfusion (65 ± 4 mm Hg) recovered 50 ± 3.9% of prearrest DLVSP and 55 ± 5% of prearrest dP/dt (
p < 0.05). Reduction in LV compliance was comparable in both groups. Mitochondrial architecture (electron microscopy) was preserved in vented hearts, but was modestly disrupted in nonvented hearts, thus suggesting slight metabolic impairment. Functional recovery was nearly complete in hearts vented only during reperfusion (DLVSP, 94 ± 10.4%; dP/dt, 89 ± 12.6%), but venting only during arrest led to functional depression (DLVSP, 50 ± 6.6%;dP/dt, 51 ± 8%;
p = 0.01). We conclude that venting chronically infarcted hearts during cardiac operations affords better myocardial protection by avoiding the damage that occurs during nonvented reperfusion.</description><subject>Anesthesia</subject><subject>Anesthesia depending on type of surgery</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Cardiac Catheterization</subject><subject>Cardiopulmonary Bypass</subject><subject>Dogs</subject><subject>Drainage</subject><subject>Heart - physiopathology</subject><subject>Heart Arrest, Induced</subject><subject>Heart Ventricles</subject><subject>Intraoperative Care</subject><subject>Medical sciences</subject><subject>Microscopy, Electron</subject><subject>Myocardial Infarction - pathology</subject><subject>Myocardial Infarction - physiopathology</subject><subject>Myocardial Infarction - therapy</subject><subject>Myocardium - pathology</subject><subject>Pressure</subject><subject>Thoracic and cardiovascular surgery. Cardiopulmonary bypass</subject><subject>Time Factors</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1985</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1r3DAQhkVJSLdpf0JAhxKSg9uRLcnyqYRN0hQCgX5dhSyNd1W88layU_bfR84ue-1pkN5nRsMjQi4YfGLA5OcfAFAVvKnFFYNrCZWAQrwhCyZEWchSNCdkcUTekncp_cnHMsdn5IxDzQHEgrR3YW2CRUfvp2BHPwTT0-9oh2eMO_rPj2v6G8Pow4q6Kc5laaLzw7bHlbf0JkZMI_WBLtdxCN6avt_RW7MxqzzyAU0c03ty2pk-4YdDPSe_7u9-Lh-Kx6ev35Y3j4XlJR-LupacK95VjSyZ61SDsnWV6lxrOo7c8BaAVw4USMAWOyNah841tZJW1dBW5-RyP3cbh79TXktvfLLY9ybgMCVdSwGcsTqDYg_aOKQUsdPb6Dcm7jQDPbvVr271LG6-enWrRe67ODwwtRt0x66DzJx_POQmZRFdzGJ9OmKKK1XJGfuyxzDLePYYdbIe5z_wEe2o3eD_s8gLR8mWig</recordid><startdate>198512</startdate><enddate>198512</enddate><creator>Mills, Stephen A.</creator><creator>Hansen, Kimberley</creator><creator>Vinten-Johansen, J.</creator><creator>Howe, Harold R.</creator><creator>Geisinger, Kim R.</creator><creator>Cordell, A. Robert</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>198512</creationdate><title>Enhanced Functional Recovery with Venting during Cardioplegic Arrest in Chronically Damaged Hearts</title><author>Mills, Stephen A. ; Hansen, Kimberley ; Vinten-Johansen, J. ; Howe, Harold R. ; Geisinger, Kim R. ; Cordell, A. Robert</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-7764484f39621df89e6bd38fdbaf4e4a4b0043d08060ebefa5bdedd9786c870b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1985</creationdate><topic>Anesthesia</topic><topic>Anesthesia depending on type of surgery</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Animals</topic><topic>Biological and medical sciences</topic><topic>Cardiac Catheterization</topic><topic>Cardiopulmonary Bypass</topic><topic>Dogs</topic><topic>Drainage</topic><topic>Heart - physiopathology</topic><topic>Heart Arrest, Induced</topic><topic>Heart Ventricles</topic><topic>Intraoperative Care</topic><topic>Medical sciences</topic><topic>Microscopy, Electron</topic><topic>Myocardial Infarction - pathology</topic><topic>Myocardial Infarction - physiopathology</topic><topic>Myocardial Infarction - therapy</topic><topic>Myocardium - pathology</topic><topic>Pressure</topic><topic>Thoracic and cardiovascular surgery. Cardiopulmonary bypass</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mills, Stephen A.</creatorcontrib><creatorcontrib>Hansen, Kimberley</creatorcontrib><creatorcontrib>Vinten-Johansen, J.</creatorcontrib><creatorcontrib>Howe, Harold R.</creatorcontrib><creatorcontrib>Geisinger, Kim R.</creatorcontrib><creatorcontrib>Cordell, A. 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Robert</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Enhanced Functional Recovery with Venting during Cardioplegic Arrest in Chronically Damaged Hearts</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>1985-12</date><risdate>1985</risdate><volume>40</volume><issue>6</issue><spage>566</spage><epage>573</epage><pages>566-573</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><coden>ATHSAK</coden><abstract>Thirty dogs with experimental myocardial infarction underwent cardiopulmonary bypass, hypothermic asanguineous K
+ cardioplegia (1 hour), and reperfusion (30 minutes). Ten hearts were vented throughout, 5 only during arrest, and 5 only during reperfusion; 10 were not vented. Left ventricular (LV) performance and compliance were assessed by isovolumic (LV balloon) indexes before bypass and after reperfusion. Vented hearts recovered 116 ± 8.3% of prearrest developed LV systolic pressure (DLVSP) and 131 ± 13.6% of prearrest rate of rise of LV pressure (dP/dt). Nonvented hearts allowed to develop pressure during arrest (11.6 ± 1.6 mm Hg) and reperfusion (65 ± 4 mm Hg) recovered 50 ± 3.9% of prearrest DLVSP and 55 ± 5% of prearrest dP/dt (
p < 0.05). Reduction in LV compliance was comparable in both groups. Mitochondrial architecture (electron microscopy) was preserved in vented hearts, but was modestly disrupted in nonvented hearts, thus suggesting slight metabolic impairment. Functional recovery was nearly complete in hearts vented only during reperfusion (DLVSP, 94 ± 10.4%; dP/dt, 89 ± 12.6%), but venting only during arrest led to functional depression (DLVSP, 50 ± 6.6%;dP/dt, 51 ± 8%;
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| subjects | Anesthesia Anesthesia depending on type of surgery Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Animals Biological and medical sciences Cardiac Catheterization Cardiopulmonary Bypass Dogs Drainage Heart - physiopathology Heart Arrest, Induced Heart Ventricles Intraoperative Care Medical sciences Microscopy, Electron Myocardial Infarction - pathology Myocardial Infarction - physiopathology Myocardial Infarction - therapy Myocardium - pathology Pressure Thoracic and cardiovascular surgery. Cardiopulmonary bypass Time Factors |
| title | Enhanced Functional Recovery with Venting during Cardioplegic Arrest in Chronically Damaged Hearts |
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