Retroperfusion of the heart with a solution of glucose, insulin, and potassium during anoxic arrest

Lolley, David M.; Hewitt, Robert L.; Drapanas, Theodore

doi:10.1016/s0022-5223(19)40508-4

Cited by 41 publications

(2 citation statements)

References 14 publications

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“…In addition, Lolley et al developed glucose cardioplegic solutions containing insulin and K + to enhance ATP production during IR, which was later found to reduce myocardial injuries in animal models of IR. [7][8][9] Cold blood cardioplegia was proposed by Buckberg 10 to arrest, perfuse and then reperfuse the myocardium with different compositions of hyperkalaemic crystalloid cardioplegic solution mixed with blood in a 1:4 ratio. Calafiore et al 11 later introduced warm blood cardioplegia containing K + /Mg 2+ which provides myocardial protection when applied continuously.…”

Section: History Of Cardioplegia In a Nutshellmentioning

confidence: 99%

Myocardial protection in cardiac surgery: how limited are the options? A comprehensive literature review

et al. 2020

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For patients undergoing cardiopulmonary bypass, myocardial protection is a key for successful recovery and improved outcomes following cardiac surgery that requires cardiac arrest. Different solutions, components and modes of delivery have evolved over the last few decades to optimise myocardial protection. These include cold and warm and blood and crystalloid solution through antegrade, retrograde or combined cardioplegia delivery approach. However, each method has its own advantages and disadvantages, posing a challenge to establish a gold-standard cardioplegic solution with an optimised mode of delivery for enhanced myocardial protection during cardiac surgery. The aim of this review is to provide a brief history of the development of cardioplegia, explain the electrophysiological concepts behind myocardial protection in cardioplegia, analyse the current literature and summarise existing evidence that warrants the use of varying cardioplegic techniques. We provide a comprehensive and comparative overview of the effectiveness of each technique in achieving optimal cardioprotection and propose novel techniques for optimising myocardial protection in the future.

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Section: History Of Cardioplegia In a Nutshellmentioning

confidence: 99%

Myocardial protection in cardiac surgery: how limited are the options? A comprehensive literature review

et al. 2020

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“…We succeeded in experimental studies on sHT using ether anesthesia and cardioplegia (Young solution + oxygenated Glucose-Insulin-Kalium (GIK) solution; Lolley et al ., 1974 ) with a CA time of 60 minutes at an esophageal temperature (ET) of 20°C ( Kanemoto et al ., 1985 , 1987 , 2003 ). We also succeeded in experimental auto-heart transplantation in a puppy during 76 minutes of CA time at an ET of 19°C using this sHT method ( Kanemoto et al ., 1989 ).…”

Section: Introductionmentioning

confidence: 99%

Open-heart techniques and mitral valve plasty for mitral regurgitation in toy- and small-breed dogs: A review

2021

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In human medicine, in the past, open-heart techniques for low-bodyweight children and newborn babies with congenital heart disease were more difficult than high-bodyweight adults. In toy- and small-breed dogs with mitral regurgitation (MR), an acquired heart disease, these techniques are more difficult to perform than for congenital heart diseases in young medium-sized or large dogs because of old age and low body weight. Therefore, improved open-heart techniques and mitral valve surgery for severe MR in older toy- and small-breed dogs are essential. Through our surface-cooling hypothermia (sHT) studies, we designed a new, improved open-heart method, namely, “the low-flow cardiopulmonary bypass (CPB) combined with deep sHT in toy- and small-breed dogs (Japan method)”; sHT was later replaced by blood-cooling hypothermia (bHT). At the same time, we devised a new, improved mitral valve plasty (MVP) applicable to severe MR, instead of mitral valve replacement, in toy- and small-breed dogs. This MVP technique was combined with artificial chordal reconstruction, semi-circular suture annuloplasty (AP), and direct scallop-suture valvuloplasty. These MVP techniques are simple, durable, and lead to good long-term quality of life in toy- and small-breed dogs. This review highlights the benefits of our improved CPB and MVP techniques (Japan method) for severe MR in toy-and small-breed dogs, which have led to a high success rate for MVP in severe clinical MR cases in Japan. It may further contribute to the development of more robust techniques for MR in toy- and small-breed dogs. This also represents the first comprehensive review of the history of open-heart surgery, CPB techniques, and MVP methods for MR in toy- and small-breed dogs.

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Perioperative Right Heart Dysfunction

Payne¹,

Cleveland²

1988

Developments in Cardiovascular Medicine

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Retroperfusion of the heart with a solution of glucose, insulin, and potassium during anoxic arrest

Cited by 41 publications

References 14 publications

Myocardial protection in cardiac surgery: how limited are the options? A comprehensive literature review

Myocardial protection in cardiac surgery: how limited are the options? A comprehensive literature review

Open-heart techniques and mitral valve plasty for mitral regurgitation in toy- and small-breed dogs: A review

Perioperative Right Heart Dysfunction

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