A comparison of methods for limiting XXXX expansion during acute reperfusion--primary role of unloading.

@entity5045 @entity235 @entity535 @entity1188 @entity583 @entity2096
Current use of angioplasty, thrombolysis, and surgical techniques for prompt reperfusion of an acute @entity583 raises questions concerning the optimum reperfusion technique for maximum myocardial salvage. Alterations in the conditions of reperfusion and/or the composition of the initial reperfusate can exert a significant effect on the extent of myocardial salvage. In an effort to define an optimum reperfusion technique, we used 40 @entity235 in a series of experiments in which the left anterior descending coronary artery (LAD) was snared for 2 hr followed by reperfusion by one of five methods for 4 hr. In addition, in a control group(group I, n = 6) the LAD was occluded for 6 hr without any reperfusion. In group 2 (n = 12), simulating medical reperfusion, reperfusion was achieved by simply releasing the snare for 4 hr. Group 3 @entity235 (n = 6) were placed on pulsatile left @entity2096 throughout 4 hr of reperfusion. Group 4 @entity235 (n = 9) were placed on percutaneous, synchronized pulsatile cardiopulmonary bypass during reperfusion. The procedure in group 5 (n = 7) @entity235 simulated coronary artery bypass grafting with cardiopulmonary bypass and cold blood, low-Ca++ cardioplegia during reperfusion. Group 6 (n = 6) was treated similarly except that during reperfusion @entity535 -enriched cardioplegia was administered by warm induction techniques. At the end of 4 hr of reperfusion, the left ventricular area of @entity1188 was determined by @entity5045 staining and expressed as a percentage of the left ventricular area at risk for @entity1188 (area of @entity1188 [AI]/area at risk [AR]).(ABSTRACT TRUNCATED AT 250 WORDS)
