Normotherm continuous blood cardioplegia for 4 hours in an in vivo pig model

Scand J Thorac Cardiovasc Surg. 1996;30(3-4):125-32. doi: 10.3109/14017439609107257.

Abstract

Warm, continuous blood cardioplegia should theoretically maintain cardiac arrest for hours without ischaemic or hypothermic injury. In the absence of in vivo studies of myocardial metabolism and ultrastructural and/or functional preservation during and after more than 2 hours of cardiac arrest and after weaning from bypass, we devised a porcine model with a closed extracorporeal circuit for the heart alone. Normothermic blood cardioplegia was administered antegrade and recirculated for 2 or 4 hours, each in seven pigs. After aortic declamping all were successfully weaned from bypass and reperfused for 1 hour. Thereafter we found no significant intergroup difference in haemodynamic characteristics (average fall in mean arterial pressure 31.7 +/- 3.2% and 26.9 +/- 2.6%) or blood analyses. After 5 and 60 minutes of cardiac arrest there was minimal lactate production (5.7 +/- 10.7 and 0.5 +/- 10.5 nmol/l, respectively), whereas in the remainder of the arrest period there was lactate uptake, indicating aerobic heart metabolism. Our setup avoids systemic hyperkalaemia, gives good cardiac protection with no deterioration between 2 and 4 hours and is well suited for studies on the quiescent, blood-perfused oxygenated heart.

MeSH terms

  • Animals
  • Blood Pressure
  • Constriction
  • Coronary Vessels / chemistry
  • Creatine Kinase / blood
  • Heart Arrest, Induced*
  • L-Lactate Dehydrogenase / blood
  • Models, Biological
  • Swine

Substances

  • L-Lactate Dehydrogenase
  • Creatine Kinase