Experimental study of intermittent crossclamping with fibrillation and myocardial protection: Reduced injury from shorter cumulative ischemia or intrinsic.

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Presentation transcript:

Experimental study of intermittent crossclamping with fibrillation and myocardial protection: Reduced injury from shorter cumulative ischemia or intrinsic protective effect? Ryuzo Bessho, MD*, David J. Chambers, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 120, Issue 3, Pages 528-537 (September 2000) DOI: 10.1067/mtc.2000.108693 Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. l. Experimental perfusion protocols Fig. l. Experimental perfusion protocols. Nine groups of hearts (n = at least 6 per group) were studied: group 1: 40 minutes of continuous global ischemia (C-GI; n = 9); group 2: a single-dose infusion of St Thomas' Hospital solution 2 (STH2) and 40 minutes of global ischemia (S-CP; n = 9); group 3: multidose infusions of STH2 (every 10 minutes) throughout 40 minutes of global ischemia (M-CP; n = 6); group 4: continuous VF throughout 40 minutes of global ischemia (C-GI+VF; n = 6); group 5: 4 × 10 minutes of global ischemia (with 10 minutes of reperfusion) (I-GI; n = 6); group 6: 4 × 10 minutes of global ischemia with intermittent STH2 (with 10 minutes of reperfusion) (I-CP; n = 6); group 7: 4 × 10 minutes of global ischemia with intermittent VF (and 10 minutes of reperfusion) (I-GI+VF; n = 6); group 8: 40 minutes of continuous VF with coronary perfusion (C-VF; n = 6); group 9: 4 × 10 minutes of VF with coronary perfusion (I-VF; n = 6). All protocols were followed by 60 minutes of reperfusion. The Journal of Thoracic and Cardiovascular Surgery 2000 120, 528-537DOI: (10.1067/mtc.2000.108693) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 2 Recovery of LVDP with reperfusion duration (minutes), expressed as a percentage of the preischemic control value. *P <.01: groups 3, 5, 6, 7, 8, and 9 versus groups 1, 2, and 4. Values are the mean of at least 6 hearts per group; error bars have been removed to improve clarity. LVDP, Left ventricular developed pressure; C-GI, continuous global ischemia group; S-CP, single-dose cardioplegic infusion group; M-CP, multidose cardioplegic infusion group; C-GI+VF, continuous global ischemia with ventricular fibrillation group; I-GI, intermittent global ischemia group; I-CP, intermittent cardioplegic infusion group; I-GI+VF, intermittent global ischemia with ventricular fibrillation group; C-VF, continuous ventricular fibrillation group; I-VF, intermittent ventricular fibrillation group. The Journal of Thoracic and Cardiovascular Surgery 2000 120, 528-537DOI: (10.1067/mtc.2000.108693) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 3 Recovery of LVDP at the end of 60 minutes of reperfusion, expressed as percentage of the preischemic control value. Values are the mean of at least 6 hearts per group ± SEM. *P <.05 vs groups 1, 2, 4, 8, and 9. LVDP, Left ventricular developed pressure; C-GI, continuous global ischemia group; S-CP, single-dose cardioplegic infusion group; M-CP, multidose cardioplegic infusion group; C-GI+VF, continuous global ischemia with ventricular fibrillation group; I-GI, intermittent global ischemia group; I-CP, intermittent cardioplegic infusion group; I-GI+VF, intermittent global ischemia with ventricular fibrillation group; C-VF, continuous ventricular fibrillation group; I-VF, intermittent ventricular fibrillation group. The Journal of Thoracic and Cardiovascular Surgery 2000 120, 528-537DOI: (10.1067/mtc.2000.108693) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 4 Changes in LVEDP during reperfusion (expressed as absolute value in millimeters of mercury). Values are the mean of at least 6 hearts per group ± SEM. LVEDP, Left ventricular end-diastolic pressure; N.S., nonsignificant; C-GI, continuous global ischemia group; S-CP, single-dose cardioplegic infusion group; M-CP, multidose cardioplegic infusion group; C-GI+VF, continuous global ischemia with ventricular fibrillation group; I-GI, intermittent global ischemia group; I-CP, intermittent cardioplegic infusion group; I-GI+VF, intermittent global ischemia with ventricular fibrillation group; C-VF, continuous ventricular fibrillation group; I-VF, intermittent ventricular fibrillation group. The Journal of Thoracic and Cardiovascular Surgery 2000 120, 528-537DOI: (10.1067/mtc.2000.108693) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions