Does intermittent coronary perfusion offer greater myocardial protection than continuous aortic cross-clamping?
There has been considerable controversy concerning the relative merits of intermittent coronary perfusion vs. continuous aortic cross-clamping for cardiac procedures requiring ischemic arrest. Using the isovolumic ventricular balloon model and “stop-freeze” biopsy techniques, myocardial contractility (LV dp/dt max, length-tension, and force-velocity relationships) and metabolism (adenine nucleotides, creatine phosphate, and glycogen) were studied in 46 intact dogs supported by normothermic cardiopulmonary bypass and subjected to either 60 minutes of continuous ischemic arrest or to four 15-minute intervals of ischemia each followed by 5 minutes of reperfusion. Following ischemia the hearts were reperfused for 30 minutes and defibrillated after the first 10 minutes. There were no significant differences in either metabolic parameters or contractile function between the groups. Although partial regeneration of adenosine triphosphate and glycogen occurred during reperfusion, only creatine
Related Questions
- Ultrastructural evidence of microvascular damage and myocardial cell injury after coronary artery occlusion: which comes first?
- Does intermittent coronary perfusion offer greater myocardial protection than continuous aortic cross-clamping?
- What is the minimum essential myocardial perfusion pressure needed to maintain coronary artery blood flow?
