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European Journal of Cardio-Thoracic Surgery, Vol 2, 25-30, Copyright © 1988 by European Association for Cardio-thoracic Surgery

ARTICLES

Preservation of myocardial energy-rich phosphates by retrograde application of Bretschneider cardioplegia during aortocoronary bypass surgery

PJ Walter, W Flameng, R Kindl and T Podzuweit
Department of Cardiovascular Surgery, University Hospital Antwerp, Belgium.

The efficacy of myocardial protection obtained by antegrade application of a cardioplegic solution was compared with that obtained by retrograde application via the coronary sinus. Myocardial preservation was assessed using biochemical parameters, i.e. tissue content of lactate, creatine phosphate, nucleotides, nucleosides and hypoxanthine. Nineteen patients undergoing routine aortocoronary bypass surgery were randomly allocated to a study group. During cardiac arrest induced by antegrade Bretschneider cardioplegia, myocardial tissue content of creatine phosphate dropped to 52% of its pre-ischemic value and degradation of nucleotides occurred, characterized mainly by an accumulation of adenosine. Retrograde cardioplegia prevented this catabolism of energy-rich phosphates completely during ischemic cardiac arrest and is therefore considered to be superior to antegrade cardioplegia.




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Copyright © 1988 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.