The potential benefits of 1.5% hetastarch as a cardioplegia additive.
BACKGROUND
Myocardial edema is a clinically relevant problem found in post-ischemic reperfused hearts. The objective of this study was to understand the effects of hetastarch-supplemented cardioplegia on post-ischemic edema and cardiac function.


METHODS
Swine hearts were arrested with either St. Thomas Hospital cardioplegia with (n=6) or without (n=7) 1.5% hetastarch. Following hypothermic global ischemia, hearts were crystalloid reperfused in a four-chamber isolated working mode.


RESULTS
Hetastarch decreased myocardial water content gains after three hours of reperfusion (control versus hetastarch, hour 0: 67+/-5% versus 67+/-3%, NS; hour 3: 82+/-2% versus 78+/-1%, p=0.1). Post-ischemic control group left ventricular end-diastolic pressures were elevated after 1h (in mm Hg, hour 0: 13+/-2, hour 1: 19+/-3, hour 2: 19+/-3, hour 3: 20+/-2) but remained stable (<16 mm Hg) in the hetastarch group. Post-reperfusion creatine phosphokinase perfusate levels in the hetastarch treated hearts were decreased (control: 1.6 IU/l/g versus hetastarch: 0.6 IU/l/g, p=0.15).


CONCLUSIONS
Hetastarch treatment delayed myocardial edema development and attenuated myocardial creatine kinase efflux, thereby preserving diastolic function.
Coles
James A
JA
Department of Surgery, University of Minnesota, 420 Delaware St. SE, MMC 107, Minneapolis, MN 55455, USA.
Sigg
Daniel C
DC
Iaizzo
Paul A
PA
D000818:Animals; D002314:Cardioplegic Solutions / Q000494:pharmacology*; D006321:Heart / Q000187:drug effects* / Q000502:physiology; D006324:Heart Arrest, Induced / Q000379:methods*; D006895:Hydroxyethyl Starch Derivatives / Q000494:pharmacology*; D066298:In Vitro Techniques; D013552:Swine
D002314:Cardioplegic Solutions; D006895:Hydroxyethyl Starch Derivatives