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THE JOURNAL OF CARDIOVASCULAR SURGERY

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The Journal of Cardiovascular Surgery 2000 February;41(1):45-50

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

Myocardial preservation in acute coronary artery occlusion with coronary sinus retroperfusion and carnitine

Katircioglu S. F., Iscan H. Z., Ulus T., Saritas Z.

From the Türkiye Yüksek Ihtisas Hospitaln Cardiovascular Surgery Clinic, Ankara * Ankara University Veterinarian Faculty, Ankara, Turkey


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Back­ground. Effec­tive­ness of ret­ro­grade cor­o­nary ­sinus per­fu­sion ­with the use of car­ni­tine sup­ple­men­ta­tion ­over the ­severity of ­ischemia/reper­fu­sion ­injury, in ­acute cor­o­nary occlu­sion.
­Methods. ­Eighteen mon­grel ­dogs, ­divided ­equally ­into con­trol, ret­ro­grade per­fu­sion (ret­ro­per­fu­sion) and car­ni­tine ret­ro­per­fu­sion (­retrocar­ni­tine) ­groups. ­After ­taking the ­basal ­values, the ­left ante­rior ­descending ­artery was ­occluded. At the fif­teenth ­minute, ­without ­ending the occlu­sion, ret­ro­grade cor­o­nary ­sinus car­di­o­plegia in the ret­ro­in­fu­sion ­group and in the car­ni­tine ­group, 0.15 ­mmol/kg of L-car­ni­tine ret­ro­per­fu­sion was per­formed. ­Then, hemo­dy­namic and bio­chem­ical meas­ure­ments ­were ­taken till the end of 120 min­utes. The con­trol ­group had no ret­ro­per­fu­sion or med­ical ­therapy.
­Results. ­Between the ­three ­groups, ­there was a sta­tis­ti­cally sig­nif­i­cant dif­fer­ence in car­diac ­index, ­mean arte­rial pres­sure, ­mean pul­mo­nary ­artery pres­sure, pul­mo­nary cap­il­lary ­wedge pres­sure, ­right ­atrial pres­sure as hemo­dy­namic param­e­ters and myo­car­dial ­oxygen extrac­tion, myo­car­dial lac­tate extrac­tion, pro­tein ­thiols and Mal­onyl dial­de­hyde (MBA) as bio­chem­ical param­e­ters, at dif­ferent ­time inter­vals (p<0.05).
Con­clu­sion. Cor­o­nary ­sinus ret­ro­per­fu­sion ­with car­ni­tine is ­found to be ­very effec­tive in ­reducing ­oxygen ­free rad­ical ­release and how­ever ­this advan­tage did not ­switch to the hemo­dy­namic func­tion ­between the ret­ro­grade cor­o­nary ­sinus infu­sion ­group and ret­ro­in­fu­sion car­ni­tine ­group. In our ­opinion ret­ro­grade cor­o­nary ­sinus per­fu­sion ­with the use of car­ni­tine sup­ple­men­ta­tion ­reduces the ­severity of ­ischemia/reper­fu­sion ­injury.

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