Potassium Cardioplegia

Wright, Robin M.; Levitsky, Sidney; Rao, Kodem S.; Holland, Charles E.; Feinberg, Harold

doi:10.1001/archsurg.1978.01370200070013

Cited by 23 publications

(5 citation statements)

References 23 publications

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“…Most cardioplegia solutions use high potassium to arrest the heart. 19 The use of hypothermic potassium-induced arrest during cardiac surgery has been shown to partially ameliorate ischemic injury by decreasing the energy demand of the myocardium.13,1B,20 Basal metabolic energy requirements are sustained under potassium-induced arrest, however, and thus still constitute a significant energy expenditure.1B It has also been reported that potassium arrest increases calcium loading in isolated cardiac myocytes and myocardial oxygen consumption in rat hearts.2o…”

Section: Cardioplegia and Cvtosolic Calcium Accumulationmentioning

confidence: 99%

Myocardial Cytosolic Calcium Accumulation During Ischemia/Reperfusion: The Effects of Aging and Cardioplegia

McCully

Tsukube

Ataka

et al. 1994

Journal of Cardiac Surgery

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Cytosollc calcium In the myocardium Is rapidly accumulated during Ischemia and has been correlated with the attenuation of functional recovery In the myocardium. The aged myocardium Is more sensitive to Ischemia and accumulates significantly more cytosollc cal· clum than either the newborn or the mature myocardium. Modification of the age-related pro· penalty to Increased cytosollc calcium accumulation may be achieved through the use of magnesium or potassium/magnesium cardioplegia. Improved postlschemlc ventricular func· tlon obtained with magnesium or potassium/magnesium cardioplegia may have Important lm· pllcatlons In the reduction of myocardial morbidity and mortality. (J Card Surg 1994; 9[Supp/]:449-452)

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Section: Cardioplegia and Cvtosolic Calcium Accumulationmentioning

confidence: 99%

Myocardial Cytosolic Calcium Accumulation During Ischemia/Reperfusion: The Effects of Aging and Cardioplegia

McCully

Tsukube

Ataka

et al. 1994

Journal of Cardiac Surgery

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“…3 The use of hypothermic potassium cardioplegic solution in adult cardiac operations increases the available global ischemic time and has been correlated with improved postischemic myocardial functional recovery and reduced postoperative mortality. 4 Potassium-induced arrest maintains the heart in a depolarized state. 5 However, depolarization also leads to the alteration of the ion flux across the sarcolemmal membrane and is associated with both increased [Ca2+]i accumulation and the significant depletion of cellular adenosine triphosphate reserves.…”

mentioning

confidence: 99%

Developmental differences in cytosolic calcium accumulation associated with surgically induced global ischemia: Optimization of cardioplegic protection and mechanism of action

Tsukube

McCully²,

Federman³

et al. 1996

The Journal of Thoracic and Cardiovascular Surgery

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“…These solutions allow for the rapid electromechanical arrest of the myocardium through alteration of cellular electrochemical gradients. 1 Most cardioplegic solutions use a high potassium content to arrest the heart. 2 The use of hypothermic potassium cardioplegia in adult cardiac surgery increases the safely available intraoperative time and has been correlated with improved postischemic myocardial functional recovery and reduced postoperative mortality.…”

mentioning

confidence: 99%

Oxygenated multidose delivery of crystalloid esmolol cardioplegia as an alternative to high potassium cardioplegia

McCully¹

2002

The Journal of Thoracic and Cardiovascular Surgery

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C ardioplegia is used as a myoprotective agent for the alleviation of surgically induced ischemic injury, incurred during cardiac operative procedures, to allow the functional preservation of the myocardium. These solutions allow for the rapid electromechanical arrest of the myocardium through alteration of cellular electrochemical gradients. 1 Most cardioplegic solutions use a high potassium content to arrest the heart. 2 The use of hypothermic potassium cardioplegia in adult cardiac surgery increases the safely available intraoperative time and has been correlated with improved postischemic myocardial functional recovery and reduced postoperative mortality. 3 Potassium-induced arrest maintains the heart in a depolarized state, significantly decreasing the energy demand of the myocardium, but basal metabolic energy requirements are sustained and thus still constitute a significant energy expenditure. 4 The advantages of cardioplegic arrest in providing a bloodless field are tempered by the fact that depolarization also leads to the alteration of ion flux across the sarcolemmal membrane and is associated with both increased cytosolic calcium accumulation and the significant depletion of cellular high-energy (adenosine triphosphate) reserves. [5][6][7][8][9] The use of blood cardioplegia is currently the criterion standard with which all cardioplegic formulations must be compared, and its benefits relative to crystalloid cardioplegia have been extensively reported. [10][11][12][13] Similarly, the relative contributions of hypothermia (cold, warm, and tepid cardioplegia) and the route of administration of cardioplegia (retrograde, antegrade, and combined retrograde and antegrade delivery) have been examined. [14][15][16][17][18] The applicability of high-potassium cardioplegia to the neonatal and immature heart remains poorly defined and will not be addressed here, but the reader is directed to reviews by del Nido 19 and Hammon 20 and the recent reviews of Allen and colleagues 21 and Ihnken 22 for further information.Despite continuous improvements in surgical technique and cardioplegic formulations, the inadequacies of current intraoperative myocardial protection protocols and formulations, most of which maintain as their basis high-potassium depolarizing arrest, remain a concern. Novel myoprotective protocols to allow enhanced functional recovery of the myocardium after ischemia and reperfusion continue to be needed. In this issue of the Journal, Bessho and Chambers 23 present evidence in favor of the use of oxygenated multidose crystalloid esmolol cardioplegia to induce cardiac arrest as an alternative to St Thomas' Hospital cardioplegic solution No. 2.Esmolol is an ultra-short acting (9-minute half-life) cardioselective ␤-blocker that is rapidly hydrolyzed by an esterase in the blood cell cytosol to an inactive form, thus avoiding the negative inotropic and chronotropic effects of prolonged ␤-block-

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Potassium Cardioplegia

Cited by 23 publications

References 23 publications

Myocardial Cytosolic Calcium Accumulation During Ischemia/Reperfusion: The Effects of Aging and Cardioplegia

Myocardial Cytosolic Calcium Accumulation During Ischemia/Reperfusion: The Effects of Aging and Cardioplegia

Developmental differences in cytosolic calcium accumulation associated with surgically induced global ischemia: Optimization of cardioplegic protection and mechanism of action

Oxygenated multidose delivery of crystalloid esmolol cardioplegia as an alternative to high potassium cardioplegia

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