Evidence of improved microvascular perfusion when using antegrade and retrograde cardioplegia
The maximum degree of microvascular distribution of cardioplegic solution is considered important to achieve optimum myocardial protection. This study attempts to demonstrate that the addition of retrograde cardioplegia to antegrade cardioplegia improves overall microvascular perfusion. Explanted hu...
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| Veröffentlicht in: | The Annals of thoracic surgery 1996-11, Vol.62 (5), p.1388-1391 |
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| container_title | The Annals of thoracic surgery |
| container_volume | 62 |
| creator | Gates, Richard N. Lee, Jeongryl Laks, Hillel Drinkwater, Davis C. Rhudis, Ehud Aharon, Alon S. Chung, Jane Y. Chang, Paul A. |
| description | The maximum degree of microvascular distribution of cardioplegic solution is considered important to achieve optimum myocardial protection. This study attempts to demonstrate that the addition of retrograde cardioplegia to antegrade cardioplegia improves overall microvascular perfusion.
Explanted human hearts (n = 6) were treated with cold cardioplegic arrest and bicaval cardiectomy. Blood cardioplegia (37°C) containing colored microspheres (color A for antegrade, color B for retrograde) was simultaneously infused antegrade at a pressure of 80 mm Hg and retrograde at a pressure of 40 mm Hg for 2 minutes. The ventricular myocardium was then sampled at three sites to determine absolute and relative cardioplegic microvascular flow.
Of the total microvascular capillary flow, 27% to 32% was found to be the contribution of retrogradely delivered cardioplegia.
Despite being delivered simultaneously and at a lower pressure, retrograde cardioplegia contributed substantially to overall microvascular perfusion. This suggests that antegrade cardioplegia alone does not perfuse all available myocardial capillaries and that the addition of retrograde cardioplegia enhances overall microvascular distribution and perfusion. |
| doi_str_mv | 10.1016/0003-4975(96)00497-3 |
| format | Article |
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Explanted human hearts (n = 6) were treated with cold cardioplegic arrest and bicaval cardiectomy. Blood cardioplegia (37°C) containing colored microspheres (color A for antegrade, color B for retrograde) was simultaneously infused antegrade at a pressure of 80 mm Hg and retrograde at a pressure of 40 mm Hg for 2 minutes. The ventricular myocardium was then sampled at three sites to determine absolute and relative cardioplegic microvascular flow.
Of the total microvascular capillary flow, 27% to 32% was found to be the contribution of retrogradely delivered cardioplegia.
Despite being delivered simultaneously and at a lower pressure, retrograde cardioplegia contributed substantially to overall microvascular perfusion. This suggests that antegrade cardioplegia alone does not perfuse all available myocardial capillaries and that the addition of retrograde cardioplegia enhances overall microvascular distribution and perfusion.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/0003-4975(96)00497-3</identifier><identifier>PMID: 8893573</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 ; Biological and medical sciences ; Cardioplegic Solutions - pharmacokinetics ; Coronary Circulation ; Drug Evaluation, Preclinical ; Heart Arrest, Induced - methods ; Humans ; Medical sciences ; Microcirculation ; Microspheres ; Pressure ; Thoracic and cardiovascular surgery. Cardiopulmonary bypass ; Time Factors ; Tissue Distribution</subject><ispartof>The Annals of thoracic surgery, 1996-11, Vol.62 (5), p.1388-1391</ispartof><rights>1996 Elsevier Science Inc</rights><rights>1997 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c468t-ad6fa7ba0bb1abb2abdd4ad00dd76f8c79ae2ca5c4bfa795c0e9251e50e121ff3</citedby><cites>FETCH-LOGICAL-c468t-ad6fa7ba0bb1abb2abdd4ad00dd76f8c79ae2ca5c4bfa795c0e9251e50e121ff3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0003-4975(96)00497-3$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2488254$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8893573$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gates, Richard N.</creatorcontrib><creatorcontrib>Lee, Jeongryl</creatorcontrib><creatorcontrib>Laks, Hillel</creatorcontrib><creatorcontrib>Drinkwater, Davis C.</creatorcontrib><creatorcontrib>Rhudis, Ehud</creatorcontrib><creatorcontrib>Aharon, Alon S.</creatorcontrib><creatorcontrib>Chung, Jane Y.</creatorcontrib><creatorcontrib>Chang, Paul A.</creatorcontrib><title>Evidence of improved microvascular perfusion when using antegrade and retrograde cardioplegia</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>The maximum degree of microvascular distribution of cardioplegic solution is considered important to achieve optimum myocardial protection. This study attempts to demonstrate that the addition of retrograde cardioplegia to antegrade cardioplegia improves overall microvascular perfusion.
Explanted human hearts (n = 6) were treated with cold cardioplegic arrest and bicaval cardiectomy. Blood cardioplegia (37°C) containing colored microspheres (color A for antegrade, color B for retrograde) was simultaneously infused antegrade at a pressure of 80 mm Hg and retrograde at a pressure of 40 mm Hg for 2 minutes. The ventricular myocardium was then sampled at three sites to determine absolute and relative cardioplegic microvascular flow.
Of the total microvascular capillary flow, 27% to 32% was found to be the contribution of retrogradely delivered cardioplegia.
Despite being delivered simultaneously and at a lower pressure, retrograde cardioplegia contributed substantially to overall microvascular perfusion. This suggests that antegrade cardioplegia alone does not perfuse all available myocardial capillaries and that the addition of retrograde cardioplegia enhances overall microvascular distribution and perfusion.</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>Biological and medical sciences</subject><subject>Cardioplegic Solutions - pharmacokinetics</subject><subject>Coronary Circulation</subject><subject>Drug Evaluation, Preclinical</subject><subject>Heart Arrest, Induced - methods</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Microcirculation</subject><subject>Microspheres</subject><subject>Pressure</subject><subject>Thoracic and cardiovascular surgery. Cardiopulmonary bypass</subject><subject>Time Factors</subject><subject>Tissue Distribution</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LAzEQhoMotVb_gcIeRPSwmmQ3-3ERpNQPKHjRo4TZZFIj-1GT3Yr_3iwtPXrKO8wzw-Qh5JzRW0ZZdkcpTeK0zMV1md1QGlKcHJApE4LHGRflIZnukWNy4v1XKHloT8ikKMpE5MmUfCw2VmOrMOpMZJu16zaoo8aqEMCroQYXrdGZwduujX4-sY1CbFcRtD2uHGgMSUcOe9dtSwVO225d48rCKTkyUHs8270z8v64eJs_x8vXp5f5wzJWaVb0MejMQF4BrSoGVcWh0joFTanWeWYKlZeAXIFQaRW4UiiKJRcMBUXGmTHJjFxt94b7vwf0vWysV1jX0GI3eJkX6TggAphuwfA_7x0auXa2AfcrGZWjVTkqk6MyWY5FSDIJYxe7_UPVoN4P7TSG_uWuH5xBbRy0yvo9xtOi4CIN2P0Ww-BiY9FJr-woX1uHqpe6s__f8Qd2OpZ0</recordid><startdate>19961101</startdate><enddate>19961101</enddate><creator>Gates, Richard N.</creator><creator>Lee, Jeongryl</creator><creator>Laks, Hillel</creator><creator>Drinkwater, Davis C.</creator><creator>Rhudis, Ehud</creator><creator>Aharon, Alon S.</creator><creator>Chung, Jane Y.</creator><creator>Chang, Paul A.</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>19961101</creationdate><title>Evidence of improved microvascular perfusion when using antegrade and retrograde cardioplegia</title><author>Gates, Richard N. ; Lee, Jeongryl ; Laks, Hillel ; Drinkwater, Davis C. ; Rhudis, Ehud ; Aharon, Alon S. ; Chung, Jane Y. ; Chang, Paul A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c468t-ad6fa7ba0bb1abb2abdd4ad00dd76f8c79ae2ca5c4bfa795c0e9251e50e121ff3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</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>Biological and medical sciences</topic><topic>Cardioplegic Solutions - pharmacokinetics</topic><topic>Coronary Circulation</topic><topic>Drug Evaluation, Preclinical</topic><topic>Heart Arrest, Induced - methods</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Microcirculation</topic><topic>Microspheres</topic><topic>Pressure</topic><topic>Thoracic and cardiovascular surgery. Cardiopulmonary bypass</topic><topic>Time Factors</topic><topic>Tissue Distribution</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gates, Richard N.</creatorcontrib><creatorcontrib>Lee, Jeongryl</creatorcontrib><creatorcontrib>Laks, Hillel</creatorcontrib><creatorcontrib>Drinkwater, Davis C.</creatorcontrib><creatorcontrib>Rhudis, Ehud</creatorcontrib><creatorcontrib>Aharon, Alon S.</creatorcontrib><creatorcontrib>Chung, Jane Y.</creatorcontrib><creatorcontrib>Chang, Paul A.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gates, Richard N.</au><au>Lee, Jeongryl</au><au>Laks, Hillel</au><au>Drinkwater, Davis C.</au><au>Rhudis, Ehud</au><au>Aharon, Alon S.</au><au>Chung, Jane Y.</au><au>Chang, Paul A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evidence of improved microvascular perfusion when using antegrade and retrograde cardioplegia</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>1996-11-01</date><risdate>1996</risdate><volume>62</volume><issue>5</issue><spage>1388</spage><epage>1391</epage><pages>1388-1391</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><coden>ATHSAK</coden><abstract>The maximum degree of microvascular distribution of cardioplegic solution is considered important to achieve optimum myocardial protection. This study attempts to demonstrate that the addition of retrograde cardioplegia to antegrade cardioplegia improves overall microvascular perfusion.
Explanted human hearts (n = 6) were treated with cold cardioplegic arrest and bicaval cardiectomy. Blood cardioplegia (37°C) containing colored microspheres (color A for antegrade, color B for retrograde) was simultaneously infused antegrade at a pressure of 80 mm Hg and retrograde at a pressure of 40 mm Hg for 2 minutes. The ventricular myocardium was then sampled at three sites to determine absolute and relative cardioplegic microvascular flow.
Of the total microvascular capillary flow, 27% to 32% was found to be the contribution of retrogradely delivered cardioplegia.
Despite being delivered simultaneously and at a lower pressure, retrograde cardioplegia contributed substantially to overall microvascular perfusion. This suggests that antegrade cardioplegia alone does not perfuse all available myocardial capillaries and that the addition of retrograde cardioplegia enhances overall microvascular distribution and perfusion.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>8893573</pmid><doi>10.1016/0003-4975(96)00497-3</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Anesthesia Anesthesia depending on type of surgery Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Cardioplegic Solutions - pharmacokinetics Coronary Circulation Drug Evaluation, Preclinical Heart Arrest, Induced - methods Humans Medical sciences Microcirculation Microspheres Pressure Thoracic and cardiovascular surgery. Cardiopulmonary bypass Time Factors Tissue Distribution |
| title | Evidence of improved microvascular perfusion when using antegrade and retrograde cardioplegia |
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