ArticleInterdisciplinary cardiovascular and thoracic surgery2025
The novel St Thomas' Hospital polarizing blood cardioplegia: results in hearts with reduced ejection fraction.
Article in Interdisciplinary cardiovascular and thoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesMyocardial protection is crucial for recovery after cardiac surgery. Despite older patients with more comorbidities, most surgeons still use potassium-induced depolarized arrest with cardioplegic solutions from more than 50 years ago. However, this can cause calcium overload, mitochondrial injury and energy depletion. We tested a new polarizing cardioplegia (STH-pol) versus traditional depolarized arrest (STH-control) in an ischaemia/reperfusion model of hearts with reduced ejection fraction.
methodsMyocardial infarction (MI) was induced by permanent ligation of the left anterior descending artery in male Sprague-Dawley rats. Six weeks post-MI, the hearts were isolated and perfused on an erythrocyte-perfused working heart system. Cold ischaemic arrest (4°C, 60 min) was induced by STH-pol (n = 10) or STH-control (n = 8), followed by reperfusion (37°C, 45 min). Haemodynamic variables were recorded throughout reperfusion, and tissue samples were taken at the end of reperfusion to analyse high-energy phosphates (HEP).
resultsAdministration of STH-pol resulted in comparable haemodynamic recovery after 60 min ischaemia as STH-control induced cardioplegic arrest (left ventricular systolic pressure: 109.1 ± 3.4 vs 103.3 ± 3.6). Similarly, HEP levels did not differ between the two groups (ATP: 2.5 ± 0.4 nmol/mg protein and 2.2 ± 0.9 nmol/mg).
conclusionsPolarizing cardioplegic arrest did not lead to a statistically significant difference in myocardial protection as compared to a clinically relevant, standard cold blood cardioplegia in rat hearts with chronic MI.
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