Does simultaneous antegrade/retrograde cardioplegia improve myocardial perfusion in the areas at risk? A magnetic resonance perfusion imaging study in.

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Does simultaneous antegrade/retrograde cardioplegia improve myocardial perfusion in the areas at risk? A magnetic resonance perfusion imaging study in isolated pig hearts Ganghong Tian, MD, PhDa, Jie Shen, PhDa, Jiankang Sun, MSca, Bo Xiang, DDSa, Godwin I. Oriaku, BSca, Luo Zhezong, MDa, Gordon Scarth, PhDa, Ray Somorjai, PhDa, John K. Saunders, PhDa, Tomas A. Salerno, MD, MScb, Roxanne Deslauriers, PhDa The Journal of Thoracic and Cardiovascular Surgery Volume 115, Issue 4, Pages 913-924 (April 1998) DOI: 10.1016/S0022-5223(98)70374-5 Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 1 Top, A representative MR perfusion image acquired along the short cardiac axis from a heart with an occluded LAD. Bottom, The same image with boundary lines defining the LAD and non-LAD regions. The Journal of Thoracic and Cardiovascular Surgery 1998 115, 913-924DOI: (10.1016/S0022-5223(98)70374-5) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 2 Experimental setups for SARC (top panel) and experimental protocol (bottom panel). Antegrade, Antegrade delivery of cardioplegic solution. The Journal of Thoracic and Cardiovascular Surgery 1998 115, 913-924DOI: (10.1016/S0022-5223(98)70374-5) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 3 Representative MR images acquired during antegrade cardioplegic solution delivery (second period) and during SARC from a group 1 heart (top images) and a group 2 heart (bottom images). No perfusion is seen in the LAD region during antegrade cardioplegic solution delivery (second period) whereas myocardium in the LAD region was partially perfused by SARC in both hearts. The Journal of Thoracic and Cardiovascular Surgery 1998 115, 913-924DOI: (10.1016/S0022-5223(98)70374-5) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 4 Representative MR images obtained during antegrade perfusion with no contrast agent (fourth period) immediately after SARC in a group 1 heart (top image) and a group 2 heart (bottom image). The images show retention of contrast agent in the LAD region, indicating that this part of myocardium was perfused during SARC. LV, Left ventricle. The Journal of Thoracic and Cardiovascular Surgery 1998 115, 913-924DOI: (10.1016/S0022-5223(98)70374-5) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 5 Time courses of signal intensity from the LAD and non-LAD regions in group 1 hearts during antegrade cardioplegic solution delivery (second period, top panel) and SARC (middle panel). The time courses of signal intensity from the LAD region during antegrade cardioplegia and SARC are shown in the bottom panel. The Journal of Thoracic and Cardiovascular Surgery 1998 115, 913-924DOI: (10.1016/S0022-5223(98)70374-5) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 6 Time courses of signal intensity from the LAD and non-LAD regions in group 2 hearts during antegrade cardioplegic solution delivery (second period, top panel) and SARC (middle panel). The time courses of signal intensity from the LAD region during antegrade cardioplegia and SARC are shown in the bottom panel. The Journal of Thoracic and Cardiovascular Surgery 1998 115, 913-924DOI: (10.1016/S0022-5223(98)70374-5) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 7 Comparison of the maximum signal intensity obtained from the LAD region and the non-LAD region during the second and third periods. The Journal of Thoracic and Cardiovascular Surgery 1998 115, 913-924DOI: (10.1016/S0022-5223(98)70374-5) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 8 A representative perfusion pattern in the LAD region during SARC. Three areas in the LAD region were identified according to their perfusion pattern (top images). The bottom graphs show the average time courses of signal intensity obtained from the corresponding areas. AU, Arbitrary units. The Journal of Thoracic and Cardiovascular Surgery 1998 115, 913-924DOI: (10.1016/S0022-5223(98)70374-5) Copyright © 1998 Mosby, Inc. Terms and Conditions