Celsior versus custodiol: early postischemic recovery after cardioplegia and ischemia at 5 degrees C.
BACKGROUND
The aim of this experimental study was to compare the protective efficacy of the cardioplegic solutions Celsior and Custodiol. Canine hearts were examined with regard to energy metabolism and early postischemic recovery after 8 or 12 hours of ischemia at 5 degrees C.


METHODS
Canine hearts were preserved with Celsior or Custodiol (each n = 19). Five hearts of each group were used to determine myocardial content of energy-rich phosphates immediately after preservation and after 8 and 12 hours of ischemia at 5 degrees C; the remainder were reperfused after 8 and 12 hours of ischemia. Control variables during reperfusion were myocardial content of energy-rich phosphates, myocardial K+ uptake, left ventricular dP/dtmax and dP/dtmin, and incidence of arrhythmias in percentage of heart rate.


RESULTS
Custodiol-preserved hearts contained more ATP than Celsior-preserved hearts after 8 and 12 hours of ischemia (8 hours p = ns, 12 hours, p < 0.05). During reperfusion after 8 hours of ischemia, dP/dtmax and dP/dtmin showed the same values for both solutions, after 12 hours values were significantly higher in Custodiol-preserved hearts (p < 0.005). The incidence of reperfusion arrhythmias was higher in hearts of the Celsior group (8 hours p < 0.01, 12 hours p = ns). Myocardial K+ uptake during reperfusion after 8 and 12 hours of ischemia was about twice as high in Celsior-preserved compared to Custodiol-preserved hearts (p < 0.005).


CONCLUSIONS
In the Langendorff model of the canine heart, cardioplegia with Celsior showed no advantage over cardioplegia with Custodiol. Differences were observed, however, which may be clinically important, especially in the case of long cold-storage times.
Ackemann
Juergen
J
Department of Experimental Surgery, University Hospital, Heidelberg, Germany. juergen.ackermann@exchi.uni-heidelberg.de
Gross
Wolfgang
W
Mory
Martin
M
Schaefer
Michael
M
Gebhard
Martha-Maria
MM
D000818:Animals; D002314:Cardioplegic Solutions / Q000494:pharmacology*; D003080:Cold Temperature; D004187:Disaccharides / Q000494:pharmacology*; D004285:Dogs; D004573:Electrolytes / Q000494:pharmacology*; D004734:Energy Metabolism; D005971:Glutamates / Q000494:pharmacology*; D005978:Glutathione / Q000494:pharmacology*; D006324:Heart Arrest, Induced; D006639:Histidine / Q000494:pharmacology*; D019157:Ischemic Preconditioning, Myocardial; D008353:Mannitol / Q000494:pharmacology*; D015425:Myocardial Reperfusion; D013997:Time Factors
D002314:Cardioplegic Solutions; C088453:Celsior; D004187:Disaccharides; D004573:Electrolytes; D005971:Glutamates; D008353:Mannitol; D006639:Histidine; D005978:Glutathione