The Annals of Thoracic Surgery, Vol 35, 280-287, Copyright © 1983 by The Society of Thoracic Surgeons
The hemodynamic and metabolic effects of cardioplegic rearrest in the pig
TA Salerno and MA Chiong
The hemodynamic and metabolic effects of two consecutive 1-hour periods of
cardioplegic arrest with a 20-minute interval of reperfusion or
cardioplegic rearrest were evaluated in pig hearts. This model was designed
to recreate in the laboratory a situation occasionally encountered during
open-heart operation. Results indicate that at the end of 40 minutes of
reperfusion following cardioplegic rearrest and 20 minutes after
cardiopulmonary bypass (CPB), the stores of glycogen, adenosine
triphosphate and total adenine nucleotides were lower than those found in
hearts beating under CPB for an identical period of time. These stores
were, however, sufficient to permit hemodynamic recovery, and they compared
favorably with those found in hearts subjected to a single hour of
cardioplegic arrest and reperfusion. The laboratory data and our previous
clinical experience suggest that cardioplegic rearrest is a feasible
alternative when surgical difficulties demand a second period of aortic
cross-clamping after an initial period of cardioplegic arrest and
reperfusion.
