Preservation of myocardial high-energy phosphates in open-heart surgery with deep general hypothermia and multidose crystalloid cardioplegia.
Myocardial energy metabolism during deep general hypothermia (20 degrees C) and multidose crystalloid cardioplegia, and also during subsequent reperfusion, was studied in eight patients undergoing isolated aortic valve replacement. Six serial transmural biopsy samples from the left ventricular apex were analyzed for high-energy phosphates and their degradation products. Reductions in ATP, total adenine nucleotide content and energy charge were insignificant during cardioplegia, as were changes in adenosine and uric acid concentrations. During reperfusion, however, there was slight but significant reduction in total adenine nucleotide content, despite adequate oxygenation as indicated by reversal of lactate accumulation. These observations suggest that the reperfusion phase is accompanied by metabolic aberrations which are not overcome by good oxygenation in relation to the metabolic rate.
Department of Clinical Physiology, Karolinska Hospital, Stockholm, Sweden.
E
E
Jansson
L
L
Bengtsson
A
A
Henze
W
W
Schmidt
A
A
Sollevi
L
L
Kaijser
D000227:Adenine Nucleotides / Q000378:metabolism*; D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001707:Biopsy, Needle; D003327:Coronary Disease / Q000378:metabolism*; D004734:Energy Metabolism; D006324:Heart Arrest, Induced; D006801:Humans; D007036:Hypothermia, Induced; D007291:Inosine Monophosphate / Q000378:metabolism*; D007292:Inosine Nucleotides / Q000378:metabolism*; D008875:Middle Aged; D009206:Myocardium / Q000032:analysis / Q000378:metabolism*; D010477:Perfusion; D014527:Uric Acid / Q000378:metabolism
D000227:Adenine Nucleotides; D007292:Inosine Nucleotides; D007291:Inosine Monophosphate; D014527:Uric Acid