Clinical Investigation

Effects of Blood Cardioplegia With Deferroxamine on Myocardial Nitric Oxide Production and Myocardial Performance

  • Tamer BAKALIM
  • Berent DISÇIGIL
  • M. Ismail BADAK
  • Mehmet BOGA
  • Ugur GÜRCÜN
  • Tahir YAGDI
  • Suat BUKET
  • Isa DURMAZ
  • Önol BILKAY

Received Date: 01.02.2000 Accepted Date: 22.03.2000 Meandros Med Dent J 2000;1(1):21-26

Objective: The effects of deferroxamine addition to routine blood cardioplegia on left ventricular function, myocardial nitric oxide (NO) production and hemodynamics were assessed. Methods: Twenty patients who underwent coronary artery bypass grafting (CABG) electively were studied in two groups, 10 in each. Ten patients in whom routine blood cardioplegia was used served as controls. In the other 10 patients (study group), blood cardioplegia with deferroxamine was used. Mean age was 61.30+2.12 in the control group, and 53.20±3.21 in the study group. The number of distal anastomoses, X-clamp and cardiopul-monary bypass (CPB) times were similar in two groups. Cardioplegia was delivered antegradely in both groups. Blood samples were taken from the coronary sinus. Hemodynamic measurements were done before and follow-ing CPB. Results: In the study group, myocardial NO levels were found to be higher at all sampling times, however, the difference was statistically significant only following CPB. Creatine kinase MB isoenzyme levels reflecting the degree of myocardial injury were measured lower in the study group postoperatively(p Conclusions: These findings demonstrate that the addition of deferroxamine to blood cardioplegic solution maintains higher myocardial NO levels indicating better endothelial function and causes less myocardial injury. Blood cardioplegia with deferroxamine is a valuable alternative method of myocardial protection during aortic cross clamping in cardiac surgery.

Keywords: Deferroxamine, nitric oxide, myocardial protection