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Use of (all-blood) miniplegia versus crystalloid cardioplegia in an experimental model of acute myocardial ischemia.
Petrucci, Orlando; Wilson Vieira, Reinaldo; Roberto do Carmo, Márcio; Martins de Oliveira, Pedro Paulo; Antunes, Nilson; Marcolino Braile, Domingo.
Afiliação
  • Petrucci O; Discipline of Cardiac Surgery, Department of Surgery, School of Medical Sciences at Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brasil. orlandopetrucci@gmail.com
J Card Surg ; 23(4): 361-5, 2008.
Article em En | MEDLINE | ID: mdl-18598329
PURPOSE: Several methods of myocardial protection have been used. The use of all-blood solutions modified with glutamate and aspartate has increased. Its use in situations of acute ischemia provides improved contractile function, "resuscitating" the previously lesioned muscle. The dilution preconized by literature is around 25% of the hematocrit. The present study evaluates an all-blood cardioplegia solution with tepid 1% dilution, denominated miniplegia. MATERIAL AND METHOD: Pigs of the Large-White breed were used with an isolated heart and perfused with blood of a support animal. Three groups (n = 7 per group) were designated with the following treatments: Control group (CO), St. Thomas solution (ST), continuous normothermic all-blood solutions (SG). After the stabilization period, systolic pressure (PS), diastolic pressure (PD), developed pressure (PD), stress of the wall, elastance, and passive stiffness were recorded. The hearts were submitted to 30 minutes of regional ischemia with the clamping of the anterior interventricular artery, and subsequently to 90 minutes of global ischemia with the use of the three different treatments during this period. At the beginning of global ischemia, the coronary clamp was removed. The hearts were again reperfused. Upon three minutes into reperfusion the hearts were defibrillated when necessary. Measurements were taken every 30 minutes to 90 minutes into reperfusion. RESULTS: The SG presented a better recovery of the ventricular function in several of the parameters recorded. The ST group was inferior to the SG group, which in turn was superior to the CO group in some of the parameters analyzed. A higher number of defibrillations were needed to reestablish coordinated heart beats in the ST and CO groups. There were no differences related to the percentage of wet weight between the SG and ST groups, and the percentage was higher in the CO group. CONCLUSION: The use of all-blood miniplegia provided superior protection when compared to global ischemia or crystalloid cardioplegia in acutely ischemic hearts. The model employed is very close to the clinical situation due to the use of blood as a perfusate.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Sangue / Isquemia Miocárdica / Compostos de Potássio / Parada Cardíaca Induzida Limite: Animals Idioma: En Revista: J Card Surg Assunto da revista: CARDIOLOGIA Ano de publicação: 2008 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Sangue / Isquemia Miocárdica / Compostos de Potássio / Parada Cardíaca Induzida Limite: Animals Idioma: En Revista: J Card Surg Assunto da revista: CARDIOLOGIA Ano de publicação: 2008 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos