The influence of prearrest factors on the preservation of left ventricular function during cardiopulmonary bypass
Butchart, E.G.; McEnany, M.T.; Strich, G.; Sbokos, C.; Austen, W.G.
Journal of Thoracic and Cardiovascular Surgery 79(6): 812-821
1980
ISSN/ISBN: 0022-5223 PMID: 7374196 Document Number: 168043
Uniformly excellent myocardial protection during global ischemia in cardiac procedures requiring cessation of aortic root perfusion remains an elusive goal. This study establishes the importance of the preischemic inotropic state of the left ventricle and the arterial blood glucose concentration ( greater than 120 mg/100 ml and treated with potassium cardioplegia, "normal" preischemic LVdp/dtmas (N = 7) was associated with a good functional result, but an elevated preischemic LVdp/dtmax (N = 6) produced severe functional impairment following ischemia. Optimum myocardial protection thus involves minimizing metabolic demands and maximizing metabolic supply immediately prior to and during the period of aortic cross-clamping.