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ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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

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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