The myocardial protection of polarizing adenosine-lidocaine cardioplegia in experimental animals / 中华胸心血管外科杂志

ABSTRACT

Objective To determine whether polarized arrest using adenosine and lidocaine cold crystalloid cardioplegia would give satisfactory myocardial protection in the cardiac surgery of experimental animals.Methods Twelve pigs were randomized divided into 2 groups (n =6) to receive adenosine-lidocaine cardioplegia or St.Thomas cardioplegia.Left ventricular systolic and diastolic function,cardiac output,cardiac troponin 1 were monitored at before operation (T1),1 hour after crossclamp was removed (T2) and 2 hours after cross-clamp was removed (T3).After T3 the left ventricular ultrastructure was observed,mitochondrial ultrastructure was analyzed by CMIAS image system.Results There were no statistical differences between the two groups in T1.The left ventricular systolic pressure,± dp/dt and cardiac output in adenosine-lidocaine group wasmuch higher than St.Thomas group in T2 and T3,meanwhile the left ventricular diastolic pressure,capillary wedge pressureand cardiac troponin Ⅰ value was lower than St.Thomas group.The hemodynamic values was more stable in adenosine-lidocaine group.St.Thomas group got more myocardial injury alterations in intracellular structure than adenosine-lidocaine group.The image analysis of mitochondrial ultrastructure shows St.Thomas group got lower shape factor,higher area density and perimeter density compared with baseline and adenosine-lidocaine group values.Conclusion Adenosine-lidocaine cold crystalloid car-dioplegia gave satisfactory cardiac arrest,got better myocardial protection than St.Thomas cardioplegia.