Comparison of right atrium incision and right ventricular outflow incision for surgical repair of membranous ventricular septal defect using cardiopulmonary bypass in dogs.

OBJECTIVE: To compare right atrium incision (RAI) and right ventricular outflow incisions (RVI) for surgical repair of membranous ventricular septal defect (VSD) facilitated by cardiopulmonary bypass (CPB). STUDY DESIGN: Retrospective study. ANIMALS: Dogs (n=10) with VSD. METHODS: Medical records of dogs that had VSD repair were reviewed. Membranous VSD without any malformation and abnormality was confirmed on several clinical examinations and by angiocardiography. RAI (5 dogs) and RVI (5 dogs) was used for VSD access and repair facilitated by CPB. Procedure comparison was by surgical duration, postoperative recovery period, and occurrence of postoperative arrhythmia. RESULTS: Duration of surgery was similar for RAI and RVI; however, postoperative recovery time was significantly reduced with RAI. Significant moderate operative damage occurred with right atrium incision. CONCLUSIONS: Right atrium incision was more effective than RVI for repair of membranous VSD using CPB. CLINICAL RELEVANCE: RAI should be considered in preference to RVI for repair of membranous VSD using CPB.

Effect of intermittent administration of sustained release isosorbide dinitrate (sr-ISDN) in rats with pressure-overload heart.

Recent studies have demonstrated the benefits of nitric oxide (NO) on myocardial hypertrophy and myocardial fibrosis. It was suggested that NO has a protective effect on myocardial cell through the neurohormonal system. This effect serves to highlight the important role of NO in maintaining the function and form of heart with chronic heart failure. However, there are no known reports about on the effect of prolonged administration of nitrate on pressure over-load heart. This study was conducted to examine the long-term effect of oral nitrate therapy in rats with pressure-overloaded heart. An abdominal aorta constricted (AC) model of pressure-overloaded heart was created in male Wistar rats. Sustained release isosorbide dinitrate (sr-ISDN) (5 mg/kg once a daily) was administered to the rats once a daily for 12 weeks. The animals were euthanized during the study period, and the heart was collected and weighed. Histopathological examination was performed to evaluate the effect of sr-ISDN on myocardial hypertrophy and fibrosis. The ratio of heart to body weight increased significantly in AC rat and this increase was significantly prevented by sr-ISDN treatment. Histopathological examination showed significant increase in fibrotic area of AC rat compared to sham rat, this increase was inhibited by sr-ISDN treatment. Cardiomyocyte transverse diameter was significantly increased in AC rat compared with sham rat, but this increase tended to decrease by sr-ISDN treatment. In conclusion, intermittent administration with sr-ISDN has mild effect in inhibiting cardiac hypertrophy and marked effect in inhibiting fibrosis due to pressure-overload.