Study of Cardiac Lymph with Special Reference to Cardiac Surgery

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The relationship between myocardial ischemia and cardiac lymph has been studied experimentally in dogs from the point of view of surgical pathophysiology. In previous study we have clarified the close relationship between ischemic myocardium and cardiac lymph production. The present series of experimental study has been prepared for analysis of the mechanism in which the ischemic myocardium is influenced by dynamical change of the cardiac lymph. The experimental study sonsists of the observation of cardiac lymph drainage and the measures for myocardial ischemia by means of control of the coronary blood flow.In the first step we recognized the fact that the extent of the area of infarction significantly correlated to the production of cardiac lymph(p 0.01). Myocardial edema was also seen in cases with myocardial ischemia. The experiment was then directed to active drainage of cardiac lymph from the myocardium succumbed to ischemia. For this purpose, hyaluronidase was given intra-venousl … More y. The result was satisfactory with increased cardiac lymph volume. We defined the area excluded from coronary flow by means of occlusion of the coronary vessel as "risk factor : R) and the area completed myocardial infarction as "infarcted area : I). The latter area was confirmed pathologically by TTC staining. In comparison of the extent between both areas by means of planimetry, the ratio of I/R significantly decreased a fter the use of hyaluronidase. The data was 33.5<plus-minus>12.3% of the left ventricular ma ss vs. 11.1<plus-minus>12.3%(p 0.00u). This phenomenon was a proof that an active drainage of cardiac lymph played an important role to selvage the ischemic myocardium. In the next, for the purpose to clarify the relationship between the flow volume of the coronary artery and the cardiac lymph volume, AC-bypass was produced for arbitrary management of the volume of the coronary blood flow. Besides, regional myocardial blood flow on the ischemic myocardium was measured using hydrogen gas clearance method. Reduction of the coronary flow to 50% of the control did not reduced the cardiac lymph flow but the regional myocardial blood flow in prominence with endocardium than epicardium (33.4% vs. 29.8%) . However in cases with hyaluronidase the result was appeared completely differed from this result. There was insignificant change between pre and post ischemia revealing 8.5% in the endocardium and only 3.0% in the epicardium, respectively. This is a significant result that prove the role of cardiac lymph under myocardial ischemia and the importance of active drainage of cardiac lymph for prevention of an ischemic damage of the myocard Less