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The Annals of Thoracic Surgery, Vol 58, 1651-1656, Copyright © 1994 by The Society of Thoracic Surgeons
N Fukushima, R Shirakura, S Nakata, M Kaneko, S Miyagawa, Y Naka, JC Chang, G Matsumiya, S Nakano and H Matsuda
To evaluate the effect of leukocyte-depleted terminal blood cardioplegia on
prolonged preservation, 41 canine hearts were stored in modified Collins'
solution and transplanted heterotopically. Hearts were transplanted soon
after harvesting in group 1 and after 24-hour preservation in groups 2, 3,
and 4. Blood cardioplegia was applied just before aortic unclamping in
groups 3 and 4; group 3 received simple blood cardioplegia and group 4
received leukocyte-depleted cardioplegia. The percentage of the preload
recruitable stroke work and diastolic compliance after transplantation
compared with the preharvesting value in group 4 did not differ from those
in group 1, but the percentage of the preload recruitable stroke work in
groups 2 and 3 was significantly lower than that in groups 1 and 4. The
percentage of diastolic compliance in groups 2 and 3 was significantly
higher than that in groups 1 and 4. Coronary blood flow 40 minutes after
aortic unclamping in group 4 did not differ from that in group 1, but was
significantly higher than the blood flows in groups 2 and 3. Significant
production of malondialdehyde was detected during terminal blood
cardioplegia and 10 minutes after aortic unclamping in groups 2 and 3, but
never in groups 1 and 4. After leukocyte-depleted terminal cardioplegia,
the myocardial adenosine triphosphate content increased to the
preharvesting value in group 4. Our results suggest that leukocyte-depleted
terminal blood cardioplegia may be effective in replenishing the
energy-depleted myocardium and reducing reperfusion injury, resulting in
adequate cardiac function.
ARTICLES
Study of efficacies of leukocyte-depleted terminal blood cardioplegia in 24-hour preserved hearts
First Department of Surgery, Osaka University Medical School, Japan.
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