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

[Abstract] [Full Text PDF] （in Japanese / 1189KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 91(9): 1427-1429, 1990

Report on the annual meeting

PROTECTION OF THE ISCHEMIC NEONATAL MYOCARDIUM
－DELECTERIOUS EFFECTS OF HIGH REPERFUSION PRESSURE－

Department of Pediatric Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical College, Tokyo, Japan
*) Department of Pediatric Cardiovascular Surgery, Children's Hospital, Boston, U.S.A.

Tadashi Fujiwara, Yasuharu Imai, John E. Mayer*), Aldo R. Castaneda*)

To investigate the effect of physical and pharmacological manipulation of reperfusion conditions on the recovery of neonatal myocardium, 30 isolated neonatal lamb hearts were subjected to 2 hours of ischemia (15C) protected with crystalloid cardioplegia. Reperfusion was begun with low pressure (20mmHg×10 min. , 40mmHg×10 min. and then 60mmHg), with high pressure (60mmHg), with high pressure and nitroglycerin continuous infusion (5mcg/min) and with high pressure and nifedipine (20mcg/L) added to the perfusion circui. Systolic and diastolic function, coronary blood flow, and myocardial water content before and afier ischemia was evaluated. It is concluded that high initial reperfusion pressure had deleterious effects on the recovery of systolic and diastolic function of the neonatal hearts associated with decreased coronary blood flow and the use of nifedipine and nitroglycerin during reperfusion enhanced the recovery of systolic and coronary blood flow in spite of high initial reperfusion pressure, but not diastolic function. These data suggested that vascular events including the endothelial cell damages during reperfusion may have an important role on the recovery of the neonatal hearts after ischemia.

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