| Project/Area Number |
04670843
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Thoracic surgery
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| Research Institution | Kansai Medical University |
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Principal Investigator |
OTANI Hajime Kansai Medical University, Intructor, 医学部, 講師 (60168979)
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| Project Period (FY) |
1992 – 1993
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| Project Status |
Completed (Fiscal Year 1993)
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| Budget Amount *help |
¥1,700,000 (Direct Cost: ¥1,700,000)
Fiscal Year 1993: ¥800,000 (Direct Cost: ¥800,000)
Fiscal Year 1992: ¥900,000 (Direct Cost: ¥900,000)
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| Keywords | open heart surgery / acute myocardial infarction / coronary artery bypass graft surgery / myocardial preservation / retrograde continuous warm blood cardioplegia / 逆行性持続warm blood cardioplegia / 逆行性冠灌流法 |
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| Research Abstract |
The effects of retrograde continuous warm blood cardioplegia (RCWBCP) on myocardial preservation during surgical revascularization for acute coronary artery occlusion was investigated using isolated in-situ dog heart model subjected to occlusion of left anterior descending artery (LAD) for 60 minutes followed by 60 minutes of cardioplegic arrest and reperfusion after release of the coronary artery occlusion. Thirty one animals were devided into 3 groups according to the manner of cardioplegic arrest. The first group of animals (n=10) recieved multiple dose of cold St. Thomas Hospital solution delivered antegradely through the aortic root. The second group of animals (n=11) recieved the same dose of the crystalloid solution delivered retrogradely through the coronary sinus. The third group of animals (n=10) recieved RCWBCP through the coronary sinus. Recovery of heart rate, aortic flow and left ventricular maximum dp/dt during reperfusion was similar among the animals (8 hearts in each group) which were capable of supporting working mode after reperfusion. Regional myocardial function in the occluded LAD distribution measured by sonomicrometer was not significantly improved during reperfusion after RCWBCP.Corresponding to these functional data myocardial pH in the occluded LAD distribution was not significantly elevated by RCWBCP during cardioplegic arrest and reperfusion. Although RCWBCP maintained myocardial pH in the circumflex artery distribution at a significantly higher level during cardioplegic arrest compared to the other two groups of hearts, it failed to prevent a decline of myocardial pH in the right ventricular free wall. These results suggest that RCWBCP after 60 minutes of LAD occlusion may not provide a signicant benefit in myocardial preservation over hypothermic crystalloid cardioplegia delivered through either antegrade or retrograde manner.
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