Cardiopulmonary support mitigates the effects of experimental myocardial ischemia.
The effectiveness of cardiopulmonary support (CPS) as a rescue method following failed angioplasty is unknown. The proximal left anterior descending (LAD) was occluded for 20 min in 21 dogs. Group 1 animals (n=15) were given CPS and group 2 animals (n=6) served as controls. During coronary occlusion, animals receiving CPS had increased mean arterial pressure (71+/- 12 vs 58+/-7 mm Hg), decreased left atrial pressure (3+/-3 vs 12+/-3 mm Hg), increased ischemic area blood flow (0.20+/-0.16 vs 0.02+/-0.04 mL/min/g) and myocardial oxygen consumption (0.014+/- 0.008 vs 0.003+/-0.006 mL O2/min/g), decreased remote area myocardial oxygen consumption (0.026+/-0.010 vs 0.091+/-0.047 mL O2/min/g), and an improved myocardial oxygen consumption index (0.60+/-0.33 vs 0.02+/-0.03) when compared with controls (p<0.05). During reperfusion (no CPS), group 1 animals had increased cardiac index (210+/-95 vs 117+/-46 mL/min/kg), renal blood flow (110+/-38% vs 53+/-45%), ischemic area blood flow (1.13+/-0.40 vs 0.58+/-0.27), and myocardial oxygen consumption (0.066+/-0.015 vs 0.032+/-0.018) when compared with controls (p<0.05). CPS improves oxidative metabolism in selective myocardial segments during coronary occlusion, promotes recovery of the postischemic myocardium, and results in improved peripheral circulation.
Ward
H B
HB
Department of Surgery, University of Minnesota, Minneapolis, 55417, USA.
McFalls
E O
EO
Baldwin
D
D
Nemzek
T G
TG
Gornick
C C
CC
D015906:Angioplasty, Balloon, Coronary; D000818:Animals; D003326:Coronary Circulation; D004285:Dogs; D005112:Extracorporeal Circulation; D005260:Female; D006439:Hemodynamics; D008297:Male; D017202:Myocardial Ischemia / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy; D009206:Myocardium / Q000378:metabolism; D010101:Oxygen Consumption