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.
    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.
    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
    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.
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      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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        • Berglund E.
        • Monroe R.G.
        • Schreiner G.L.
        Myocardial oxygen consumption and coronary blood flow during potassium-induced cardiac arrest and during ventricular fibrillation.
        Acta Physiol. Scand. 1967; 41: 261
        • Beuren A.
        • Sparks C.
        • Bing R.J.
        Metabolic studies on the arrested and fibrillating perfused heart.
        Am. J. Cardiol. 1958; 1: 103
        • Björk V.O.
        • Fors B.
        Induced cardiac arrest.
        J. Thorac. Cardiovasc. Surg. 1961; 41: 387
        • Cobb F.R.
        • Wallace A.G.
        • Wagner G.S.
        Cardiac inotropic and coronary vascular responses to countershock.
        Circ. Res. 1968; 23: 731
        • Ebert P.A.
        • Greenfield L.J.
        • Austen W.G.
        • Morrow A.G.
        Experimental comparison of methods for protecting the heart during aortic occlusion.
        Ann. Surg. 1962; 155: 25
        • Effler D.B.
        • Groves L.K.
        Elective cardiac arrest with potassium citrate.
        in: Allen J.G. Extracorporeal circulation. Charles C Thomas, Publisher, Springfield, Ill1958
        • Giammona S.T
        • Lurie P.R.
        • Segar W.E.
        Hypertonicity following selective angiocardiography.
        Circulation. 1963; 28: 1096
        • Helmsworth J.A.
        • Kaplan S.
        • Clark L.C.
        • McAdams A.J.
        • Matthews E.C.
        • Edwards F.K.
        Myocardial injury associated with asystole induced with potassium citrate.
        Ann. Surg. 1959; 149: 200
        • Kirsch U.
        • Rodewald G.
        • Kalmár P.
        Induced ischemic arrest.
        J. Thorac. Cardiovasc. Surg. 1972; 63: 121
        • McKeever W.P.
        • Gregg D.E.
        • Canney P.C.
        Oxygen uptake of the nonworking left ventricle.
        Circ. Res. 1958; 6: 612
        • Melrose D.G.
        • Dreyer B.
        • Bentall H.H.
        • Baker J.B.E.
        Elective cardiac arrest.
        Lancet. 1955; 2: 21
        • Miller D.R.
        • Rasmussen P.
        • Klionsky B.
        Reversibility of morphologic changes following elective cardiac arrest.
        Ann. Surg. 1964; 159: 208
        • Mundth E.D.
        • Sokol D.M.
        • Levine F.H.
        • Austen W.G.
        Evaluation of methods for myocardial protection during extended periods of aortic cross-clamping and hypoxic cardiac arrest.
        Bull. Soc. Int. Chir. 1970; 4: 227
        • Redo S.F.
        An evaluation of various cardioplegic methods utilizing isolated perfused guinea pig hearts.
        Surg. Gynecol. Obstet. 1959; 108: 211
        • Reis R.L.
        • Cohn L.H.
        • Morrow A.G.
        Effects of induced ventricular fibrillation on ventricular performance and cardiac metabolism.
        Circulation. 1967; 35 and 36: 1-234
        • Sabiston Jr., D.C.
        • Gregg D.E.
        Effect of cardiac contraction on coronary blood flow.
        Circulation. 1957; 15: 14
        • Sanger P.W.
        • Robicsek F.
        • Dougherty H.K.
        • Gallucci V.
        • Lasage M.A.
        Topical cardiac hypothermia in lieu of coronary perfusion.
        J. Thorac. Cardiovasc. Surg. 1966; 52: 533
        • Sealy W.C.
        • Brown Jr., I.W.
        • Young Jr., W.G.
        • Stephen C.R.
        • Harris J.S.
        Hypothermic low flow extracorporeal circulation for controlled cardiac arrest for open heart surgery.
        Surg. Gynecol. Obstet. 1957; 104: 441
        • Sealy W.C.
        • Young Jr., W.G.
        • Brown Jr., I.W.
        • Lesage A.
        • Callaway Jr., H.A.
        • Harris J.S.
        • Merritt D.H.
        Potassium, magnesium and neostigmine for controlled cardioplegia.
        Arch. Surg. 1958; 77: 33
        • Shumway N.E.
        • Lower R.R.
        Topical cardiac hypothermia for extended periods of anoxic cardiac arrest.
        in: Surg. Forum. 10. 1960: 563
        • Webb W.R.
        • Dodds R.P.
        • Unal M.O.
        • Kerow A.M.
        • Cook W.A.
        • Daniel C.R.
        Suspended animation of the heart with metabolic inhibitors.
        Ann. Surg. 1966; 164: 343
        • Zinner C.
        • Gottlob R.
        Morphologic changes in vessel endothelia caused by contrast media.
        Angiology. 1959; 10: 207