Reperfusion with venous blood after cardioplegic arrest during bypass surgery results in faster microbubble transit rates compared to arterial blood: Evidence for less endothelial injury?

Jonathan Lindner, William D. Spotnitz, Matthew Bayfield, Suad Ismail, N. Craig Goodman, Sanjiv Kaul

Research output: Contribution to journalArticle

Abstract

During cardiopulmonary bypass, both delivery of cardioplegic solutions and reperfusion result in endothelial dysfunction. It has been previously shown that sonicated albumin microbubbles adhere to injured endothelium and that the transit rate of these microbubbles can be measured using myocardial contrast echocardiography (MCE). We, therefore, hypothesized that endothelial dysfunction caused by cardioplegia and reperfusion can be detected using MCE. The myocardial transit rate of microbubbles injected into the aortic root was measured in 12 dogs and 12 patients during cardioplegia delivery and reperfusion with arterial and venous blood after cardioplegic arrest. The myocardial transit rates of 99mTc-labeled red blood cells and similarly labeled 5% human albumin were also measured and the cardioplegic solutions were sampled for biochemical analysis. In comparison to the red blood cell and albumin transit rates which remained constant at a given flow rate regardless of the composition of the cardioplegic solution infused, microbubble transit rates were markedly slower during delivery of crystalloid cardioplegic solutions (p<0.001). They increased significantly when blood was added to these solutions (p2, pCO2, or K+. These results indicate that endothelial dysfunction during cardioplegic arrest and after reperfusion may be ameliorated with use of cardioplegic solutions containing venous rather than arterial blood. They also imply that MCE could be used to assess endothelial function on-line in the operating room.

Original languageEnglish (US)
Pages (from-to)389
Number of pages1
JournalJournal of the American Society of Echocardiography
Volume10
Issue number4
StatePublished - 1997
Externally publishedYes

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Cardioplegic Solutions
Microbubbles
Reperfusion
Echocardiography
Albumins
Induced Heart Arrest
Wounds and Injuries
Erythrocytes
Operating Rooms
Cardiopulmonary Bypass
Endothelium
Dogs

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Reperfusion with venous blood after cardioplegic arrest during bypass surgery results in faster microbubble transit rates compared to arterial blood: Evidence for less endothelial injury?",
abstract = "During cardiopulmonary bypass, both delivery of cardioplegic solutions and reperfusion result in endothelial dysfunction. It has been previously shown that sonicated albumin microbubbles adhere to injured endothelium and that the transit rate of these microbubbles can be measured using myocardial contrast echocardiography (MCE). We, therefore, hypothesized that endothelial dysfunction caused by cardioplegia and reperfusion can be detected using MCE. The myocardial transit rate of microbubbles injected into the aortic root was measured in 12 dogs and 12 patients during cardioplegia delivery and reperfusion with arterial and venous blood after cardioplegic arrest. The myocardial transit rates of 99mTc-labeled red blood cells and similarly labeled 5{\%} human albumin were also measured and the cardioplegic solutions were sampled for biochemical analysis. In comparison to the red blood cell and albumin transit rates which remained constant at a given flow rate regardless of the composition of the cardioplegic solution infused, microbubble transit rates were markedly slower during delivery of crystalloid cardioplegic solutions (p<0.001). They increased significantly when blood was added to these solutions (p2, pCO2, or K+. These results indicate that endothelial dysfunction during cardioplegic arrest and after reperfusion may be ameliorated with use of cardioplegic solutions containing venous rather than arterial blood. They also imply that MCE could be used to assess endothelial function on-line in the operating room.",
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AU - Bayfield, Matthew

AU - Ismail, Suad

AU - Craig Goodman, N.

AU - Kaul, Sanjiv

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