The Effect Of Cold Autologous Blood Cardioplegic Solution To Energy Metabolism And Mitochondria Of Immature Cardiocyte

PrefaceIdeal cardioplegic solution is an important step and an effective means to myocardial protection. Because there are many physiological differences in cardiac structure between immature and mature myocardium, to seek adaptive cardioplegic solution on the immature myocardium is helpful to improve postoperative cardiac function and prognosis, so as to improve the surgery achievement ratio and reduce medical costs. ATP contents of immature cadiocytes is decreased and mitochondria is damaged by Reperfusion injury directly, when intraoperative cardiac arrest resuscitation occurs. Cardiac function and postoperative hemodynamics are also affected.ObjectiveContrasting ATP contents and mitochondria of immature cadiocytes effected by autologous blood cardioplegic solution and HTK solution, is to demonstrate its protective effect on the immature cadiocytes. Suggestion can be provided for reforming the method of myocardial preservation in open heart operation by this study.Methods36 children of age under 1-year-old with repair of ventricular septal defect in cardiopulmonary bypass were included and randomly grouped into two units:" autologous blood cardioplegia " (n=19; Groupâ… ) and " HTK solution " (n=17; Groupâ…¡). ATP& ADP contents of Right atrial appendage were measured by HPLC prior to asystole (Time 1) and 30 minutes after re-beating (Time 2), with each of (50mg) of the specimens being extracted respectively. Right atrial appendage cadiocytes ultrastructure, particularly evaluated mitochondria by Flameng's method, were observed by electron microscope. By studying the differences in the two groups of indicators, results is obtained by the use of statistical t test method.Results1. During the aorta clamped, ATP and ADP contents of cadiocytes in two groups have not statistical difference (P>0.05). While after the aorta unclamping, the difference become significant (P<0.01). The contents decrease significantly after the aorta unclamping in both groups (P<0.01). The reduction of ATP contents is increased after the aorta unclamping in control group (P<0.01). While the reduction of ADP contents in two groups have not statistical difference (P>0.05).2. Before the aorta clamped, the structure of mitochondria maintained as originally. Loss of Matrix granule and swelling of mitochondriums is found by chance. After the aorta unclamping, damage in mitochondria is found, such as loss of Matrix granule and cristae breaken.3. The scores of evaluation by Flameng's is increased after the aorta unclamping in both groups (P<0.01). The scores of the control group is higher than the one in experimental group (P<0.05).Conclusions1. ATP contents of immature cadiocytes is increased after applying autologous blood cardioplegic solution undergoing open heart operation.2. Reperfusion injury of immature cadiocytes mitochondria is relieved by using autologous blood cardioplegic solution. It plays an important role in recovering energy metabolism of cadiocytes.3. Immature cadiocytes is protected significantly by autologous blood cardioplegic solution rather than HTK solution.