STUDY OF THE 30 MINUTES FOLLOWING REPERFU SION AFTER CRYSTALLOID AND BLOOD CARDIOPLEGIA BY ENZYMATIC AND METABOLIC ANALYSIS OF THE CORONARYBLOOD-FLOW

Post-ischemic reperfusion phenomena were studied in two methods of myo cardial protection: crystalloid cardioplegia (St Thomas n degrees 2) a nd cold blood cardioplegia (Buckberg) during cardiopulmonary bypass fo r human myocardial revascularisation. Myocardial protection was assess ed on the course of hemodynamic parameters, reperfusion arrhythmias an d biochemical analysis of the coronary flow after cross-clamp removal: creatine phosphokinase (CPK-MB) and nucleotide adenine metabolites (a denosine, inosine, hypoxanthine, xanthine and uric acid). The study wa s performed in two groups of 14 patients. Hemodynamic conditions were similar in both groups during reperfusion in order to avoid different coronary flow. Under these conditions, myocardial protection by cold b lood cardioplegia reduced reperfusion arrhythmias, and resulted in a l oss of CPK-MB release. Furthermore, cold blood cardioplegia provided p rotection of myocardial energy metabolism by reducing the loss of meta bolites, purine bases and oxypurine bases into the coronary sinus. Our results also show that hypoxanthine is probably the final product of ATP degradation ill human myocardial tissue.