Comparison of Myocardial Protection Effects Between Enriched Crystalloid Cardioplegia Solution and St. Thomas Solution: An Experimental Study on Oryctolagus cuniculus
Abstract
Background: Cardioplegic solutions are critical for myocardial protection during cardiac surgery. Enriched Crystalloid Cardioplegia (ECC), modified from the St. Thomas solution with added mannitol, MgSO₄, and lidocaine, may enhance protection. This study conducted to compare the myocardial protection efficacy of ECC and St. Thomas solution in rabbits during ischemia
Methods: Eighteen male Oryctolagus cuniculus rabbits were randomized into three groups (n=6 each): ECC, St. Thomas, and control (Ringer Lactate). Cardioplegia was administered via antegrade aortic root infusion (15 mL/kg, 25°C, single dose). After 90 minutes of aortic cross-clamping, myocardial tissues were collected at 30, 60, and 90 minutes for histological evaluation using H&E staining. Outcome measures included myocardial injury score, extent of damage, and neutrophil infiltration.
Results: ECC showed significantly lower injury scores at 30 and 60 minutes compared to control (p= 0.027 & p= 0.018). No significant difference was found between ECC and St. Thomas. At 90 minutes, differences were not statistically significant. No significant differences were observed in infarct size or neutrophil infiltration between groups.
Conclusion: ECC offers myocardial protection comparable to St. Thomas solution, with a trend toward prolonged efficacy. Its additional agents may enhance protective mechanisms during cardiac arrest
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Chambers DJ, Fallouh HB. Cardioplegia: the developing science of myocardial protection. Eur J Cardiothorac Surg. 2010;38(3):219–29.
Glöckner A, Böttiger BW, Meinhardt A. Myocardial protection in cardiac surgery. J Thorac Dis. 2021;13(6):3984–4002.
Zhu X, et al. Myocardial histological injury scoring. J Mol Cell Cardiol. 2002;34(3):233–9.
Bayat P, et al. Histopathologic scoring of myocardial infarction. Cardiovasc Pathol. 2002;11(1):21–8.
Mueller M, Klinke A, David S, et al. Evaluation of neutrophil infiltration in myocardial tissue using immunohistochemical techniques. J Mol Histol. 2017;48(4):289–96.
Sanetra K, et al. Mannitol in myocardial protection: antioxidant and osmotic effects. Thorac Cardiovasc Surg. 2018;66(1):20–8.
Ferreira R, et al. Mannitol improves myocardial mitochondrial preservation during ischemia. J Thorac Cardiovasc Surg. 1989;98(3):530–7.
Shakerinia M, et al. Magnesium in cardioplegia and its myocardial effects. Ann Thorac Surg. 1996;61(5):1323–30.
Ahmed A, et al. Meta-analysis of Del Nido cardioplegia: efficacy of lidocaine and magnesium. J Card Surg. 2024;39(1):13–22.
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