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Thorac Cardiovasc Surg 2003; 51(5): 249-254
DOI: 10.1055/s-2003-43082
Original Cardiovascular
© Georg Thieme Verlag Stuttgart · New York

Leukocyte-depleted Secondary Blood Cardioplegia Attenuates Reperfusion Injury after Myocardial Ischemia

A.  Civelek1 , M.  Roth1 , P.  Lemke1 , W.  P.  Klövekorn1 , E.  P.  Bauer1
  • 1Department of Thoracic and Cardiovascular Surgery, Bad Nauheim, Germany
Further Information

Publication History

Received: April 8, 2003

Publication Date:
22 October 2003 (online)

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Abstract

Background: Activated neutrophils have been implicated in reperfusion injury of the myocardium; leukocyte depletion at the time of reperfusion may contribute to better myocardial protection after cardiac surgery. In the present study, we examined whether leukocyte depletion as an adjunct to terminal blood cardioplegia attenuates reperfusion injury. Methods: Porcine hearts that had undergone 60 minutes of normothermic ischemia with cardioplegia and 60 minutes of reperfusion under cardiopulmonary bypass were divided into four groups according to the methods of 15 min of controlled initial reperfusion: whole blood reperfusion (n = 6), leukocyte-depleted reperfusion (n = 6), secondary blood cardioplegia (n = 6) and leukocyte-depleted secondary blood cardioplegia (n = 6). At 60 min of reperfusion, hemodynamic recovery, release of malondialdehyde (MDA) as a marker for free oxygen radicals, CK-MB-isoenzyme from the coronary sinus, recovery of adenosine triphosphate, and myocardial water content were evaluated. Results: The group with leukocyte-depleted secondary blood cardioplegia showed the best hemodynamic recovery (Emax and total dp/dt), lowest levels of MDA, CK-MB and myocardial water content, and highest adenosine triphosphate recovery. Conclusions: These results suggest that controlled reperfusion with leukocyte-depleted secondary blood cardioplegia attenuated severe damage of the myocardium as compared to whole blood reperfusion.

Key words

Leukocyte depletion - reperfusion - secondary blood cardioplegia - myocardial recovery

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Matthias Roth

Department of Thoracic and Cardiovascular Surgery, Kerckhoff Clinic Foundation

Benekestraße 2-8

61231 Bad Nauheim, Germany

Phone: +49 (6032) 996-2502

Fax: +49 (6032) 996-2567

Email: Matthias.Roth@kerckhoff.med.uni-giessen.de