Myocardial Protection with Bretschneider Cardioplegic Solution – An Evaluation of Full Oxygenation

Abstract

In the present study the effect of oxygenated Bretschneider cardioplegia on high-energy phosphates [adenosine triphos-phate (ATP), adenosine diphosphate (ADP) and creatine phosphate (CP)] and hemodynamics was evaluated in the isolated working rabbit heart. Hearts were obtained from 37 adult white Elco rabbits (3,100 ± 110 g). After a 20-min working period 14 hearts were arrested with Bretschneider cardioplegia (8 °C) oxygenated with 98% oxygen (O₂) and 2% carbon dioxide in comparison to 14 hearts receiving Bretschneider solution saturated with 98% nitrogen (N₂) and 2% carbon dioxide as a control group for either 60 or 90 min (O₂6O, O₂90, N₂60, N₂90 groups, n = 7). Seven hearts were used to determine preischemic baseline values of ATP, ADP and CP, 2 were excluded. The results showed a significantly poorer preservation of high-energy phosphates in hearts receiving oxygenated Bretschneider cardioplegia as compared to hearts receiving nitrogenated cardioplegia (p < 0.05). Postischemic recovery of hemodynamics did not demonstrate any statistically significant differences between the groups. However, the intragroup analysis showed a tendency towards weaker hemodynamic recovery in hearts treated with oxygenated cardioplegia. These results stay in contrast to the beneficial effect of oxygenated St. Thomas solution. In conclusion our findings suggest that oxygenated Bretschneider cardioplegia leads to significantly poorer preservation of high-energy phosphates and depressed hemodynamic recovery.

Basic and applied research at the department of cardio-thoracic surgery: work in progress

“…Today, we can offer a wide spectrum of animal models reaching from the mouse and rat to rabbits and pigs. The major achievements in the improvement of periand intraoperative myocardial protection were the systematic investigations on different cardioplegic solutions in the adult and immature heart, later the effects of possible additives and adjuncts to standard cardioplegic solutions to improve postischemic functional and metabolic recovery [23][24][25][26][27][28][29][30]. In particular we studied the effects of ACE inhibitors and NO donors during ischemia and reperfusion in healthy and failing hearts and were the first to underline the concept of integrated myocardial and endothelial protection (together with Seth Hallström and Harald Gasser) [31][32][33], which could also improve donor and recipient management in cardiac transplantation [34,35].…”