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Society of University Surgeons| Volume 74, ISSUE 2, P284-290, August 1973

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Functional, metabolic, and morphologic effects of potassium-induced cardioplegia

  • William A. Gay Jr.
    Correspondence
    Reprint requests: Dr. William A. Gay, Jr., Department of Surgery, New York Hospital-Cornell University Medical Center, 525 E. 68th St., New York, N. Y. 10021.
    Footnotes
    Affiliations
    From the Department of Surgery, The New York Hospital-Cornell University Medical Center, New York, N. Y., U.S.A.
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  • Paul A. Ebert
    Affiliations
    From the Department of Surgery, The New York Hospital-Cornell University Medical Center, New York, N. Y., U.S.A.
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  • Author Footnotes
    1 Dr. Gay is recipient of a career development award from the Irma T. Hirschl Charitable Trust.
DOI:https://doi.org/10.5555/uri:pii:0039606073900627
Functional, metabolic, and morphologic effects of potassium-induced cardioplegia
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      Abstract

      An isolated, supported heart preparation was used to evaluate the metabolic, functional, and morphologic effects of cardioplegia induced by injection of an osmotically balanced solution of high potassium concentration. When compared to the beating, nonworking heart, the paced heart, and the fibrillating heart, a fourfold decrease in oxygen consumption was found in the arrested heart. A slight decrease in coronary vascular resistance occurred in the arrested heart compared to the spontaneously beating, paced, or fibrillated heart, but no difference in lactate extraction was demonstrated. In another group of studies ten hearts subjected to 60 minutes of normothermic ischemia, after potassium-induced arrest, showed only a mild reduction in ventricular function, while ten hearts subjected to 60 minutes of ischemia alone were not viable enough to have their function assessed. Histologic examination of potassium-arrested hearts after 60 minutes of ischemia showed no cellular or nuclear damage while the ischemic hearts showed widespread evidence of extensive damage. The current trends in cardiac surgery point toward the need for extended periods of cardiac standstill and, based on the results of these studies, it is considered that reduction of metabolic activity can safely be accomplished with an osmotically balanced high-potassium solution. Additional studies to evaluate the systemic effects of hyperkalemia in the intact organism supported by extracorporeal circulation seem warranted.
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      Article info

      Footnotes

      ☆This investigation was supported in part by National Institute of Health grants HL-01782-17 and 5-RO1-HL14267.

      ☆☆A part of this investigation was accomplished in the Department of Surgery, Duke University Medical Center, Durham, N. C.

      ★Presented at the Thirty-fourth Annual Meeting of the Society of University Surgeons, New Orleans, La., Feb. 8–10, 1973.

      Identification

      DOI: https://doi.org/10.5555/uri:pii:0039606073900627

      Copyright

      © 1973 Published by Elsevier Inc.

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