[Electrophysiological evaluation of retrograde cardioplegia--experimental study of efficacy for the right ventricle]

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[Electrophysiological evaluation of retrograde cardioplegia--experimental study of efficacy for the right ventricle] Abstract Text:

H Utsunomiya,M Ikeshita,T Shoji,

Recently, coronary artery bypass grafting operations for patients with total proximal multi-vessel coronary obstructions are increased. In these cases, antegrade cardioplegia through the aortic root has been applied as usual. But it seems to be difficult to deliver cardioplegic solution to myocardium uniformly beyond coronary stenosis. Retrograde coronary sinus cardioplegia in the presence of proximal coronary artery obstruction could maintain improved cardioplegic delivery and satisfactory myocardial protection. Because of the limitation of antegrade cardioplegia, retrograde cardioplegic technique has, once again, been cited as a reasonable alternative to antegrade cardioplegia. But on the other hand, retrograde cardioplegia includes the potential for relatively inadequate preservation of right ventricle based on the venous drainage communication to the coronary sinus. The object of the present work is mainly to evaluate the efficacy of retrograde coronary sinus cardioplegic technique for right ventricle by electrophysiological method. Thirty-six adult mongrel dogs divided three groups. Sixteen animals (Group I) received GIK cardioplegia through the coronary sinus, thirteen animals (Group II) received GIK added diltiazem cardioplegia through the same way, and seven animals (Group III) received GIK cardioplegia through aortic root. No large temperature gradients of myocardium between right and left ventricle in each group and also temperature gradients of right ventricle between three groups have been observed. The time duration from starting of injection of cardioplegia to disappear the electrical activity in right and left ventricle were 11.4 +/- 8.2, 3.4 +/- 1.2 minutes in group I, 2.9 +/- 1.5, 2.2 +/- 1.4 minutes in group II, and 0.9 +/- 0.4, 0.9 +/- 0.2 minutes in group III. The time duration from starting of injection of cardioplegia to reappear the electrical activity in right and left ventricle were 6.4 +/- 8.7, 13.4 +/- 7.9 minutes in group I, 20.0 +/- 3.5, 21.3 +/- 1.6 minutes in group II and 18.0 +/- 5.5, 18.7 +/- 4.5 minutes in group III. Unipolar peak-to-peak amplitude (UPPA) analysis reveals the condition of myocardial preservation during ischemic arrest and we compared preischemic UPPA with post-ischemic UPPA. In group I, UPPA declined of 44.1 +/- 29.3% in right ventricle and 72.7 +/- 27.6% in left ventricle, in group II, 78.7 +/- 28.7%, 81.9 +/- 23.6%, in group III, 71.4 +/- 18.7%, 76.7 +/- 9.89%. Analysis of ultrastructural changes in the myocardium are shown that injury was most manifest in the right ventricle of group I, but in group II, ultrastructure of right ventricle maintained nearly normal condition.(ABSTRACT TRUNCATED AT 400 WORDS)

[Electrophysiological evaluation of retrograde cardioplegia--experimental study of efficacy for the right ventricle] Publishing Authors By Initials

H Utsunomiya,M Ikeshita,T Shoji,

For similar circulatory and respiratory physiology: cardiovascular physiology: cardiovascular physiologic processes: ventricular function: ventricular function, right research abstracts see: circulatory and respiratory physiology: cardiovascular physiology: cardiovascular physiologic processes: ventricular function: ventricular function, right research

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[Electrophysiological evaluation of retrograde cardioplegia--experimental study of efficacy for the right ventricle] Journal Published:

PUBLICATION TYPE: Journal Article

Journal: [Zasshi] [Journal]. Nihon Ky?bu Geka Gakkai

VOLUME: 38

Page Numbers: 2039-48

Journal Abbreviation:

ISSN: 0369-4739

DAY: 14

MONTH: Oct

YEAR: 1990

[Electrophysiological evaluation of retrograde cardioplegia--experimental study of efficacy for the right ventricle] Information

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LANGUAGE: jpn

NlmUniqueID: 19130180

[Electrophysiological evaluation of retrograde cardioplegia--experimental study of efficacy for the right ventricle] Keywords Mesh Terms:

KEYWORDS: Ventricular Function, Right

MESH TERMS: ultrastructure

Chemical & Substance for Abstract: [Electrophysiological evaluation of retrograde cardioplegia--experimental study of efficacy for the right ventricle] Information

Substance Name: Cardioplegic Solutions

Registry Number: 0

Grant and Affiliation Information for [Electrophysiological evaluation of retrograde cardioplegia--experimental study of efficacy for the right ventricle]

AFFILIATION: Department of Thoracic and Cardiovascular Surgery, Nippon Medical School, Tokyo, Japan.

Country: JAPAN

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MEDLINETA: Nippon Kyobu Geka Gakkai Zassh

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