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Experimental Evaluation of Coronary Infusates in Dogs

Experimental Evaluation of Coronary Infusates in Dogs Abstract • In a study involving dogs, a coronary infusate containing a variety of substances including cardiac substrates, metabolic inhibitors, membrane stabilizers, electrolytes, and anticoagulants was evaluated in terms of protection afforded to the myocardium for up to 90 minutes of normothermic anoxic arrest. Electron microscopical studies and tissue adenosine triphosphate measurements revealed this coronary infusate to be considerably beneficial to the myocardium. Infused myocardium was better preserved compared to myocardium that was not infused or infused with two other "control" infusates. The individual components of our infusate are known cardiac preservatives. The rationale for combining a number of them in our infusate is to produce an additive or synergetic effect through beneficial intervention at several points in the cardiac metabolic cycle. This objective appears to have been fulfilled under the conditions of the present experiment. (Arch Surg 110:1374-1382, 1975) References 1. Lundsgaard-Hansen P: Surgical aspects of cardiac metabolism . Surg Gynecol Obstet 122:1095-1108, 1966. 2. Kones RJ: Metabolism of the acutely ischemic and hypoxic heart . Crit Care Med 1:321-330, 1973.Crossref 3. Jennings RB, Ganote CE: Structural changes in myocardium during acute ischemia . Circ Res 35( (suppl 3) ):156-172, 1974. 4. Lev M, Birkner ML, Idriss FS, et al: Extracorporeal circulation effect on dog's heart . Arch Pathol 79:257-269, 1965. 5. Cerra FB, Lajos TZ, Montes M, et al: Structural-functional correlates of reversible myocardial anoxia . J Surg Res 16:140-152, 1974.Crossref 6. Dhalla NS, Singh JN, Fedelesova M, et al: Biochemical basis of heart function: XII. Sodium-potassium stimulated adenosine triphosphatase activity in the perfused rat heart made to fail by substrate-lack . Cardiovasc Res 8:227-236, 1974.Crossref 7. Isom OW, Kutin ND, Falk EA, et al: Patterns of myocardial metabolism during cardiopulmonary bypass and coronary perfusion . J Thorac Cardiovasc Surg 66:705-721, 1973. 8. Gomes OM, Pedroso FI, Pereira SN, et al: Mitochondrial enzymatic alterations produced in the myocardium by anoxic arrest . J Thorac Cardiovasc Surg 67:649-658, 1974. 9. Merchant FJ, Feinberg H, Levitsky S: Sequential analysis of altered myocardial metabolism and contractility induced by normothermic arrest and reperfusion . J Surg Res 16:153-161, 1974.Crossref 10. Benzing G, Stockert J, Nave E, et al: Intermittent myocardial ischemia during cardiopulmonary bypass . J Thorac Cardiovasc Surg 65:108-111, 1973. 11. Sanmarco ME, Marquez LA, Hall C, et al: Myocardial contractility following cardiopulmonary bypass with and without myocardial ischemia . Ann Thorac Surg 8:237-251, 1969.Crossref 12. Cohn LH, Fujiwara Y, Kirk E, et al: Effects of local cardiac hypothermia on the magnitude and distribution of coronary blood flow and on myocardial function and metabolism . Ann Thorac Surg 19:10-16, 1975.Crossref 13. Roe BB, Stoney RJ: Ventricular function after myocardial ischemia at various levels of hypothermia . J Cardiovasc Surg 4:483-488, 1963. 14. Rheinlander FH, Wallace WH, Robeles AJ: The effects of hypothermia on the metabolism of the post-arrested canine heart . J Cardiovasc Surg 6:126-133, 1965. 15. DeWall RA, Vasko KA, Stanley EL, et al: Responses of the ischemic myocardium to allopurinol . Am Heart J 82:362-370, 1971.Crossref 16. Crowell JW, Jones CE, Smith EE: Effect of allopurinol on hemorrhagic shock . Am J Physiol 216:744-748, 1969. 17. Nakae S, Webb WR, Salyer KE, et al: Extended survival of the normothermic anoxic heart with metabolic inhibitors . Ann Thorac Surg 3:37-42, 1967.Crossref 18. Tyers GFO, Todd GJ, Neely JR, et al: The mechanism of myocardial protection from ischemic arrest by intracoronary tetrodotoxin administration . J Thorac Cardiovasc Surg 69:190-195, 1975. 19. Brown AH, Niles NR, Braimbridge MV, et al: The combination of adenosine-triphosphatase inhibition and provision of high-energy phosphates for the preservation of unperfused myocardium, assessed by ventricular function, histochemistry and birefringence . J Cardiovasc Surg 42:602-616, 1969. 20. Spath JA, Lane DL, Leker AM: Protective action of methylprednisolone on the myocardium during experimental myocardial ischemia in the cat . Circ Res 35:44-51, 1974.Crossref 21. Moffitt EA, Molnar GD, Pluth JR, et al: Effects on metabolism and cardiac output of glucose-potassium solution, with and without insulin . Ann Thorac Surg 15:1-14, 1973.Crossref 22. Weisfeldt ML, Scully HE, Selden R, et al: Effect of mannitol on the performance of the isolated canine heart after fibrillatory arrest . J Thorac Cardiovasc Surg 66:290-299, 1973. 23. Iyengar SRK, Ramchand S, Charrette EJP, et al: An experimental study of subendocardial hemorrhagic necrosis after anoxic cardiac arrest . Ann Thorac Surg 13:214-224, 1972.Crossref 24. Sacks SA, Petritsch PH, Kaufman JJ: Canine kidney preservation using a new perfusate . Lancet 1:1024-1028, 1973.Crossref 25. Jones CE, Parker JC, Smith EE, et al: Determination of myocardial acid-soluble adenine nucleotides on anion-exchange thin layers . J Chromatogr 64:378-382, 1972.Crossref 26. Tyers GFO, Hughes HC, Todd GJ, et al: Protection from ischemic cardiac arrest by coronary perfusion with cold Ringer's lactate solution . J Thorac Cardiovasc Surg 67:411-418, 1974. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Experimental Evaluation of Coronary Infusates in Dogs

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References (26)

Publisher
American Medical Association
Copyright
Copyright © 1975 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1975.01360170114017
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Abstract

Abstract • In a study involving dogs, a coronary infusate containing a variety of substances including cardiac substrates, metabolic inhibitors, membrane stabilizers, electrolytes, and anticoagulants was evaluated in terms of protection afforded to the myocardium for up to 90 minutes of normothermic anoxic arrest. Electron microscopical studies and tissue adenosine triphosphate measurements revealed this coronary infusate to be considerably beneficial to the myocardium. Infused myocardium was better preserved compared to myocardium that was not infused or infused with two other "control" infusates. The individual components of our infusate are known cardiac preservatives. The rationale for combining a number of them in our infusate is to produce an additive or synergetic effect through beneficial intervention at several points in the cardiac metabolic cycle. This objective appears to have been fulfilled under the conditions of the present experiment. (Arch Surg 110:1374-1382, 1975) References 1. Lundsgaard-Hansen P: Surgical aspects of cardiac metabolism . Surg Gynecol Obstet 122:1095-1108, 1966. 2. Kones RJ: Metabolism of the acutely ischemic and hypoxic heart . Crit Care Med 1:321-330, 1973.Crossref 3. Jennings RB, Ganote CE: Structural changes in myocardium during acute ischemia . Circ Res 35( (suppl 3) ):156-172, 1974. 4. Lev M, Birkner ML, Idriss FS, et al: Extracorporeal circulation effect on dog's heart . Arch Pathol 79:257-269, 1965. 5. Cerra FB, Lajos TZ, Montes M, et al: Structural-functional correlates of reversible myocardial anoxia . J Surg Res 16:140-152, 1974.Crossref 6. Dhalla NS, Singh JN, Fedelesova M, et al: Biochemical basis of heart function: XII. Sodium-potassium stimulated adenosine triphosphatase activity in the perfused rat heart made to fail by substrate-lack . Cardiovasc Res 8:227-236, 1974.Crossref 7. Isom OW, Kutin ND, Falk EA, et al: Patterns of myocardial metabolism during cardiopulmonary bypass and coronary perfusion . J Thorac Cardiovasc Surg 66:705-721, 1973. 8. Gomes OM, Pedroso FI, Pereira SN, et al: Mitochondrial enzymatic alterations produced in the myocardium by anoxic arrest . J Thorac Cardiovasc Surg 67:649-658, 1974. 9. Merchant FJ, Feinberg H, Levitsky S: Sequential analysis of altered myocardial metabolism and contractility induced by normothermic arrest and reperfusion . J Surg Res 16:153-161, 1974.Crossref 10. Benzing G, Stockert J, Nave E, et al: Intermittent myocardial ischemia during cardiopulmonary bypass . J Thorac Cardiovasc Surg 65:108-111, 1973. 11. Sanmarco ME, Marquez LA, Hall C, et al: Myocardial contractility following cardiopulmonary bypass with and without myocardial ischemia . Ann Thorac Surg 8:237-251, 1969.Crossref 12. Cohn LH, Fujiwara Y, Kirk E, et al: Effects of local cardiac hypothermia on the magnitude and distribution of coronary blood flow and on myocardial function and metabolism . Ann Thorac Surg 19:10-16, 1975.Crossref 13. Roe BB, Stoney RJ: Ventricular function after myocardial ischemia at various levels of hypothermia . J Cardiovasc Surg 4:483-488, 1963. 14. Rheinlander FH, Wallace WH, Robeles AJ: The effects of hypothermia on the metabolism of the post-arrested canine heart . J Cardiovasc Surg 6:126-133, 1965. 15. DeWall RA, Vasko KA, Stanley EL, et al: Responses of the ischemic myocardium to allopurinol . Am Heart J 82:362-370, 1971.Crossref 16. Crowell JW, Jones CE, Smith EE: Effect of allopurinol on hemorrhagic shock . Am J Physiol 216:744-748, 1969. 17. Nakae S, Webb WR, Salyer KE, et al: Extended survival of the normothermic anoxic heart with metabolic inhibitors . Ann Thorac Surg 3:37-42, 1967.Crossref 18. Tyers GFO, Todd GJ, Neely JR, et al: The mechanism of myocardial protection from ischemic arrest by intracoronary tetrodotoxin administration . J Thorac Cardiovasc Surg 69:190-195, 1975. 19. Brown AH, Niles NR, Braimbridge MV, et al: The combination of adenosine-triphosphatase inhibition and provision of high-energy phosphates for the preservation of unperfused myocardium, assessed by ventricular function, histochemistry and birefringence . J Cardiovasc Surg 42:602-616, 1969. 20. Spath JA, Lane DL, Leker AM: Protective action of methylprednisolone on the myocardium during experimental myocardial ischemia in the cat . Circ Res 35:44-51, 1974.Crossref 21. Moffitt EA, Molnar GD, Pluth JR, et al: Effects on metabolism and cardiac output of glucose-potassium solution, with and without insulin . Ann Thorac Surg 15:1-14, 1973.Crossref 22. Weisfeldt ML, Scully HE, Selden R, et al: Effect of mannitol on the performance of the isolated canine heart after fibrillatory arrest . J Thorac Cardiovasc Surg 66:290-299, 1973. 23. Iyengar SRK, Ramchand S, Charrette EJP, et al: An experimental study of subendocardial hemorrhagic necrosis after anoxic cardiac arrest . Ann Thorac Surg 13:214-224, 1972.Crossref 24. Sacks SA, Petritsch PH, Kaufman JJ: Canine kidney preservation using a new perfusate . Lancet 1:1024-1028, 1973.Crossref 25. Jones CE, Parker JC, Smith EE, et al: Determination of myocardial acid-soluble adenine nucleotides on anion-exchange thin layers . J Chromatogr 64:378-382, 1972.Crossref 26. Tyers GFO, Hughes HC, Todd GJ, et al: Protection from ischemic cardiac arrest by coronary perfusion with cold Ringer's lactate solution . J Thorac Cardiovasc Surg 67:411-418, 1974.

Journal

Archives of Surgery – American Medical Association

Published: Nov 1, 1975

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