[A study of the 30 minutes following reperfusion after crystalloid and cold blood cardioplegia by enzymatic and metabolic analysis of coronary blood flow].
Post-ischemic reperfusion phenomena were studied in two methods of myocardial protection: crystalloid cardioplegia (St Thomas n(o) 2) and cold blood cardioplegia (Buckherg) during cardiopulmonary bypass for human myocardial revascularisation. Myocardial protection was assessed on the course of hemodynamic parameters, reperfusion arrhythmias and biochemical analysis of the coronary flow after cross-clamp removal: creatine phosphokinase (CPK-MB) and nucleotide adenine metabolites (adenosine, inosine, hypoxanthine, xanthine and uric acid). The study was performed in two groups of 14 patients. Hemodynamic conditions were similar in both groups during reperfusion in order to avoid different coronary flow. Under these conditions, myocardial protection by cold blood cardioplegia reduced reperfusion arrhythmias, and resulted in a loss of CPK-MB release. Furthermore, cold blood cardioplegia provided protection of myocardial energy metabolism by reducing the loss of metabolites, purine bases and oxypurine bases into the coronary sinus. Our results also show that hypoxanthine is probably the final product of ATP degradation in human myocardial tissue.
Obadia
J F
JF
Service de Chirurgie Cardiothoracique et vasculaire, Höpital Cardiologique Louis-Pradel, Hospices Civils de Lyon, BP Lyon-Montchat.
Ben Baouali
A
A
Maupoil
V
V
Rochette
L
L
D000368:Aged; D001803:Blood Transfusion; D002314:Cardioplegic Solutions / Q000494:pharmacology*; D003080:Cold Temperature; D003326:Coronary Circulation / Q000187:drug effects*; D003402:Creatine Kinase / Q000378:metabolism; D005260:Female; D006324:Heart Arrest, Induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000601:surgery; D015428:Myocardial Reperfusion Injury / Q000201:enzymology / Q000378:metabolism*; D009204:Myocardial Revascularization; D011687:Purines / Q000378:metabolism
D002314:Cardioplegic Solutions; D011687:Purines; D003402:Creatine Kinase
Etude des 30 minutes suivant la reperfusion après cardioplégies cristalloïdes et sanguines par analyse enzymatique et métabolique de l' effluent coronaire.