Db. Schmit et al., SAFE EX-VIVO CORONARY ANGIOGRAPHY WITH ISOSMOTIC CONTRAST AGENT, Journal of thoracic and cardiovascular surgery, 112(2), 1996, pp. 306-309
Plain-film coronary angiography of the cardiac explant on the operatin
g table should be considered when conventional cardiac catheterization
is desired but unavailable. We compared the effects of three contrast
solutions on cold-preserved, isolated guinea pig hearts. Hearts were
excised, perfused for 30 minutes, and arrested with Plegisol solution
at 7 degrees C. Twenty minutes after arrest, experimental hearts were
perfused with one of three solutions: hyperosmolar Hexabrix solution (
n = 6), hyperosmolar Renografin-76 solution (n = 6), or diluted, isosm
otic Omnipaque solution (n = 8). The hearts were flushed with cold Ple
gisol solution 5 minutes later. Control hearts received no contrast du
ring arrest (n = 9). The hearts were reperfused after 1 hour of arrest
, and coronary blood Bow (in millimeters per minute), left ventricular
developed pressure (in millimeters of mercury), and rate of developed
pressure (in millimeters of mercury per second) were measured, Endoth
elium-dependent smooth muscle relaxation to bradykinin administration
and endothelium-independent relaxation to sodium nitroprusside adminis
tration were also assessed, No significant difference in myocardial or
endothelial function was noted between control hearts and hearts perf
used with Omnipaque solution. Hearts perfused with Renografin solution
or Hexabrix solution, however, were found to have significantly impai
red endothelial and myocardial function. We conclude that an isosmotic
contrast solution should be used for ex vivo coronary angiography in
cold-preserved hearts to avoid impairment of endothelial and myocardia
l function.