J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 6681KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 82(8): 850-859, 1981

Original article

MYOCARDIAL PROTECTING EFFECT OF CORONARY PERFUSION WITH COLD LACTATED RINGERS SOLUTION PLUS MANNITOL

1) Department of Thoracic Surgery, Wakayama Medical College
2) Department of Anatomy 1, Wakayama Medical College

Sumio Matsuoka1), Motoyuki Takimoto1), Takeo  Sakurai1), Osamu  Nishimura1), Hisao Ohta1), Shuichi Tokutsu1), Yoshiyuki Yamaoka1), Ken Kodama1), Yoshio Suzuki1), Kazuo Okada1), Katsumi Enomoto1), Naniwa Okada1), Tajimi Hirohata2)

To evaluate myocardial protection by coronary perfusion with cold lactated Ringer's solution plus mannitol this experimental and clinical study was carried out. In experiment, normothermic diluted blood, cold lactated Ringer's solution (270mOsm) (G A), only 1000ml cold lactated Ringer's solution plus 200ml 20% mannitol (400mOsm) (G B) and 1000 ml cold lactated Ringers Solution plus 500 ml 20% mannitol (600mOsm) (G C) were used as perfusates for coronary circulation and myocardial protective effects of each perfusate were studied Myocardial-protecting effect of each perfusate was evaluated by isoenzymes in serum (CPK-MB, LDH1+2), left ventricular function (Vmax, LVEDP, CO) and ultrastructure of myocardium. There was no significant difference in myocardial change between normothermic diluted blood and cold lactated Ringer's solution plus mannitol (400mOsm). Left ventricular enddiastolic pressure significantly increased only in G A and significant increase of CPK-MB was seen only in G C. Mitochondrial scores of each group were 86 (G A). 93 (G B) and 51 (G C). Minimal myocardial damage was seen in G B.
Clinically all 25 patients operated upon by using aortic root perfusion with cold lactated Ringer's solution (400mOsm) under the aortic cross clamping (27-144 min.) survived and CPK-MB returned to preoperative values within 48 hours after operation. In 6 cases, ultrastructure of left ventricular papillary muscle was examined.It was confirmed that no significant change of mitochondria developed during aortic cross clamp.

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