CARDIOPULMONARY SUPPORT MITIGATES THE EFFECTS OF EXPERIMENTAL MYOCARDIAL-ISCHEMIA

The effectiveness of cardiopulmonary support (CPS) as a rescue method following failed angioplasty is unknown. The proximal left anterior de scending (LAD) was occluded for 20 min in 21 dogs. Group 1 animals (n= 15) were given CPS and group 2 animals (n=6) served as controls. Durin g coronary occlusion, animals receiving CPS had increased mean arteria l pressure (71+/-12 vs 58+/-7 mm Hg), decreased left atrial pressure ( 3+/-3 vs 12+/-3 mm Hg), increased ischemic area blood now (0.20+/-0.16 vs 0.02+/-0.04 mL/min/g) and myocardial oxygen consumption (0.014+/-0 .008 vs 0.003+/-0.006 mL O-2/min/g), decreased remote area myocardial oxygen consumption (0.026+/-0.010 vs 0.091+/-0.047 mL O-2/min/g), and an improved myocardial oxygen consumption index (0.60+/-0.33 vs 0.02+/ -0.03) when compared with controls (p<0.05). During reperfusion (no CP S), group 1 animals had increased cardiac index (210+/-95 vs 117+/-46 mL/min/kg), renal blood flow (110+/-38% vs 53+/-45%), ischemic area bl ood flow (1.13+/-0.40 vs 0.58+/-0.27), and myocardial oxygen consumpti on (0.066+/-0.015 vs 0.032+0.018)when compared with controls (p<0.05) CPS improves oxidative metabolism in selective myocardial segments dur ing coronary occlusion, promotes recovery of the postischemic myocardi um, and results in improved peripheral circulation.