Effect of Combined Cold and Pharmacological Ischaemic Cardioplegia on Myocardial Intrinsic Sympatho-Adrenergic System During Coronary Bypass Surgery

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Abstract
The effect of combined cold and pharmacological ischemic cardioplegia on the structural integrity and the degree of the functional activity of the inbuilt intrinsic sympatho-adrenergic nervous system was studied by fluorescence microscopy of atrial myocardial biopsies obtained in the course of coronary bypass surgery on 8 consecutive patients. The specimens were taken before starting extracorporeal circulation (controls) and at decannulation (i.e., after cold cardioplegic ischemic asystole and subsequent coronary reperfusion). The cardioplegia was induced by perfusing the coronary arteries via the aortic root with cold cardioplegic solution after starting extracorporeal circulation, venting the left ventricle and cross-clamping the ascending aorta. The specimens were processed for semi-quantitative fluorescence histochemical analysis. No changes were observed. The procedure of the combined cold and pharmacological ischemic cardioplegia obviously preserves well the neural noradrenaline [norephinephrine] of the heart, a vital means of compensating for decreasing myocardial contractility. All patients made a smooth convalescence.
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