Introduction Myocardial preservation during open heart surgeries and harvesting for transplant
are of great importance. The heart at the end of procedure has to resume its
functions as soon as possible. All cardioplegic solutions are based on potassium
for induction of cardioplegic arrest. Objective To assess a cardioplegic solution with no potassium addition to the formula with
two other commercially available cardioplegic solutions. The comparative
assessment was based on cytotoxicity, adenosine triphosphate myocardial
preservation, and caspase 3 activity. The tested solution (LIRM) uses low doses of
sodium channel blocker (lidocaine), potassium channel opener (cromakalin), and
actin/myosin cross bridge inhibitor (2,3-butanedione monoxime). Methods Wistar rats underwent thoracotomy under mechanical ventilation and three
different solutions were used for "in situ" perfusion for cardioplegic arrest
induction: Custodiol (HTK), Braile (G/A), and LIRM solutions. After cardiac
arrest, the hearts were excised and kept in cold storage for 4 hours. After this
period, the hearts were assessed with optical light microscopy, myocardial ATP
content and caspase 3 activity. All three solutions were evaluated for direct
cytotoxicity with L929 and WEHI-164 cells. Results The ATP content was higher in the Custodiol group compared to two other solutions
(P<0.05). The caspase activity was lower in the HTK group
compared to LIRM and G/A solutions (P<0.01). The LIRM solution
showed lower caspase activity compared to Braile solution
(P<0.01). All solutions showed no cytotoxicity effect after 24
hours of cells exposure to cardioplegic solutions. Conclusion Cardioplegia solutions without potassium are promised and aminoacid addition
might be an interesting strategy. More evaluation is necessary for an optimal
cardioplegic solution development.