J.Jpn. Surg. Soc.. 82(11): 1314-1320, 1981

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Original article

OPTIMAL PERFUSION PRESSURE DURING REPERFUSION AFTER CARDIOPLEGIA

An experiment was designed to determine the optimal perfusion pressure during early reperfusion after cardioplegia for one hour at 28℃ of myocardial temperature, assessed by cardiac function, biochemistry and fine structure of left ventricle. Under cardioplumonary bypass at a constant flow rate of 80ml/kg/min, ascending aorta was clamped for one hour. After the aorta was declamped, the dogs were devided into three groups by the perfusion pressure of 50 (Group A), 80 (Group B) and 150mmHg (Group C) for 15 minutes of reperfusion. Left ventricular function was measured and calculated. Myocardial enzymes (m-GOT, MB-CPK) in the coronary sinus venous blood were measured. Myocardial ATP, cratine phosphate (CP) and water content were measured at the end of experiment. The subendocardium of the left ventricle was examined by electron microscopy. Mortality were 0/7 in group A, 0/6 in group B and 4/7 in group C. After cardioplegia, SI and CI were maintained in the highest level, and the water content of the subendocardium was the lowest in group A. Also the ultrastracture was well maintained in group A compared to the others. These data suggest that high perfusion pressure is detrimental to myocardial recovery during early reperfusion, and the optimal perfusion pressure during early reperfusion after cardioplegia (60 min, 28℃) appears to be 50mmHg.

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