Myocardial Protection by Cardioplegic Solutions

  • N. Bleese
Conference paper

Abstract

The aim of myocardial protection in coronary bypass surgery is to guarantee the functional and structural integrity of the whole myo­cardium which should be independent of the preoperative myocardial and coronary conditions and the number of grafted coronary arteries. The evidence of perioperative myocardial infarctions occurring with­in a zone of myocardium supplied by an ungrafted artery or myocardi­al infarctions occurring in regions supplied by arteries, which are grafted from patent veins, demonstrates that none of the methods of intraoperative myocardial protection in coronary bypass surgery until now was fully able to guarantee this.

Keywords

Starch Magnesium Ischemia Europe Lactate 

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References

  1. 1.
    Assad-Morell, J.L., Frye, R.L., Connolly, D.C., Gau, G.T., Pluth, J.R., Barnhorst, D.A., Wallace, R.B., Davis, G.D., Elveback, L.R., Danielson, G.K.: Relation of intraoperative or early postoperative transmural myocardial infarction to patency of aortocoronary bypass grafts and to diseases ungrafted coronary arteries. Am. J. Cardiol. 35, 767 (1975)PubMedCrossRefGoogle Scholar
  2. 2.
    Bleese, N., Döring, V., Gercken, G., Pokar, H., Rodewald, G.: Long-time cardiac arrest by cardioplegic perfusion. 10th Congress of the European Society for Experimental Surgery. Paris, 6.-9. April 1975Google Scholar
  3. 3.
    Bleese, N., Döring, V., Gercken, G., Kalmar, P., Lierse, W., Pokar, H., Polonius, M.-J., Steiner, D., Rodewald, G.: Langzeitherzstillstand durch cardioplegische Coronarperfusion. Thoraxchirurgie 24, 468 (1976)Google Scholar
  4. 4.
    Bretschneider, H.J.: Überlebenszeit und Wiederbelebungszeit des Herzens bei Normo- und Hypothermie. Verh. Dtsch. Kreislaufforsch. 30, 11 (1964)Google Scholar
  5. 5.
    Döring, V., Gercken, G., Bleese, N., Pokar, H., Rodewald, G.: Long time cardiac arrest by cardioplegic coronary perfusion. Pflügers Arch. 355 [Suppl.] R 10 (1975)Google Scholar
  6. 6.
    Döring, V., Baumgarten, H.G., Pokar, H., Gercken, G.: Metabolism and fine structure of the Mg++-procaine arrested perfused heart. Basic Res. Cardiol. 70, 186 (1975)PubMedCrossRefGoogle Scholar
  7. 7.
    Döring, V., Baumgarten, H.G., Bleese, N., Kalmar, P., Pokar, H., Gercken, G.: Metabolism and structure of the magnesium aspartate-procaine arrested ischemic heart of rabbit and man. Basic Res. Cardiol. 71, 119 (1976)Google Scholar
  8. 8.
    Gay, W.A. (Jr.), Ebert,,P.A.: Functional, metabolic and morphological effects of potassium-induced cardioplegia. Surgery 74, 284 (1973)PubMedGoogle Scholar
  9. 9.
    Hottenrott, C.E., Maloney, J.V., Buckberg, G.: Studies of the effects of ventricular fibrillation on the adequacy of regional myocardial blood flow. J. Thorac. Cardiovasc. Surg. 68, 615 (1974)PubMedGoogle Scholar
  10. 10.
    Kalmar, P., Bleese, N., Kirsch, U., Lutz, G., Pokar, H., Rodewald, G.: Kombination von Kardioplegie i;nd Coronarperfusion bei Herzoperationen in Normothermie. Thoraxchirurgie 20, 427 (1972)Google Scholar
  11. 11.
    Kalmar, P., Bleese, N., Döring, V., Gercken, G., Kirsch, U., Lierse, W., Pokar, H., Polonius, M.-J., Rodewald, G.: Induced ischemic arrest. Clinical and experimental results with magnesium aspartate procaine solution (caropleginR). J. Cardiovasc. Surg. 16, 470 (1975)Google Scholar
  12. 12.
    Kirsch, U., Rodewald, G., Kalmar, P.: Induced ischemic arrest. Clinical experience with cardioplegia in open heart surgery. J. Thorax. Cardiovasc. Surg. 63, 121 (1972)Google Scholar
  13. 13.
    Kolff, W.J., Effler, D.B., Groves, L.K., Peereboom, G., Maraca, P.P., Aoyama, S., Sones, F.M.: Elective cardiac arrest by the Melrose technic: Potassium asystole for experimental cardiac surgery. Clev. Clin. Q. 23, 98 (1956)Google Scholar
  14. 14.
    Melrose, D.G., Dreyer, B. , Bentall, H.H., Baker, J.B.: Elective cardiac arrest: Preliminary communication. Lancet1955/11, 21Google Scholar
  15. 15.
    Shumway, N.E., Lower, R.TR., Stofer, R.C.: Selective hypothermia of the heart in anoxic cardiac arrest. Surg. Gynecol. Obstet. 109, 750 (1959)PubMedGoogle Scholar
  16. 16.
    Søndergaard, T., Senn, A.: Klinische Erfahrungen mit der Kardioplegie nach Bretschneider. Langenbecks Arch. Klin. Chir. 319, 661 (1967)CrossRefGoogle Scholar
  17. 17.
    Steiner, D., Bleese, N., Döring, V., Roesner, K.: Prevention of edema during coronary perfusion with cardioplegic solution. Thoraxchirurgie 25, 235 (1977)Google Scholar
  18. 18.
    Stemmer, E.A., McCart, P., Stanton, W.W., Thibault, W., Dearden, L.S., Conolly, J.E.: Functional and structural alterations in the myocardium during aortic crossclamping. J. Thorac. Cardiovasc. Surg. 70, 666 (1975)PubMedGoogle Scholar
  19. 19.
    Wukasch, D.C., Reul, G.J., Milam, J.D., Halman, G.L., Cooley, D.A.: The “stone-heart” syndrom. Surgery 72, 1071 (1972)PubMedGoogle Scholar

Copyright information

© Springer Verlag Berlin Heidelberg 1979

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  • N. Bleese

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