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Myocardial Metabolism in Patients Having Aortic-valve Replacement.

Moffitt, Emerson A. M.D.; Rosevear, John W. M.D.; Townsend, Clary H. M.D.; McGoon, Dwight C. M.D.

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Concentrations of metabolites and electrolytes in arterial and coronary sinus blood were studied in ten patients undergoing whole-body perfusion for aortic valve replacement. The study continued through three postoperative days. A comparison was made between five patients whose hearts were beating during perfusion and five whose hearts fibrillated. Oxygen consumption of the myocardium was reduced during hypothermic coronary perfusion; the reduction was greater in the beating hearts. Significant arterial-coronary sinus differences in electrolytes and osmolality were not seen. Arterial concentrations of energy metabolites utilized by the myocardium were elevated throughout operation, and all except glucose were utilized by the heart. Ketosis persisted after operation in the presence of above-normal glucose levels. Other than greater consumption of oxygen during perfusion, no consistent difference was seen between the performances of hearts that fibrillated and those that continued to beat.
(C) 1969 American Society of Anesthesiologists, Inc.
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