EXPERIMENTAL-STUDY OF CARDIAC LYMPH DYNAMICS AND EDEMA FORMATION IN ISCHEMIA REPERFUSION INJURY - WITH REFERENCE TO THE EFFECT OF HYALURONIDASE/

This study is designed to evaluate the effect of hyaluronidase on the canine myocardial edema derived from ischemia/reperfusion injury. The mongrel dog's heart received 90 minutes of ischemia under cardiopulmon ary bypass consisting of 30 minutes of normothermia alone and 60 minut es of hypothermia with cardioplegic arrest. Reperfusion for 60 minutes was added thereafter. Two kinds of cardioplegic solution, 4 degrees C St. Thomas' Hospital solution with or without 3000 units/L of hyaluro nidase, were prepared. The solution was given antegradely every 30 min utes during cardioplegic arrest. Cardiac lymph was collected continuou sly from the afferent duct of the cardiac lymph node by cannulation. H yaluronidase in the cardioplegic solution increased cardiac lymph volu me significantly and improved postischemic recovery of cardiac functio n. A high level of adenosine triphosphate was maintained at that time. The myocardial water content at the end of reperfusion revealed a min imum increase with hyaluronidase use. Active drainage of cardiac lymph by hyaluronidase alleviates the myocardial edema formation, thereby p reserving cardiac function.