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Critical Care

Volume 3 Supplement 2

International Symposium on the Pathophysiology of Cardiopulmonary Bypass

Open Access

Evaluation of myocardial cell damage in cardiac lymph during cardiopulmonary bypass

  • JF Vazquez-Jimenez1,
  • Ma Qing1,
  • OJ Liakopoulos1,
  • RG Grabitz1,
  • G von Bernuth1,
  • BJ Messmer1 and
  • MC Seghaye1
Critical Care19993(Suppl 2):P25

Published: 2 March 1999


Cardiopulmonary BypassCoronary SinusMyocardial InjuryInterstitial SpaceSignificant Release


Cardiac lymph is a medium which reflects the myocardial interstitial space. The purpose of our study was to evaluate the inflammatory response marker TNFα (tumor necrosis factor-α) and myocardial injury marker Troponin I during cardiopulmonary bypass (CPB) in cardiac lymph and to compare them with blood values taken from the coronary sinus (SC).


In 14 young pigs the efferent cardiac lymph trunk and the SC was cannulated before starting CPB. Concentration of TNFα and Troponin I were measured pre, during and post CPB.


A significant release of TNFα in SC and cardiac lymph was not observed.

Troponin I values in SC-blood rose from 2 ± 1.1ng/ml (mean ± SEM) before aortic cross-clamping (AoX) to 9.1 ± 3.2 ng/ml at the end of CPB and peaked 2 hours post CBP at 28.1 ± 10.9 ng/ml (P < 0.03). Troponin I concentration in cardiac lymph rose from 352 ± 64 ng/ml before AoX and became significantly higher in the following hours with a maximum value at 6 hours post CPB (12638 ± 5321 ng/ml; P < 0.01). A significant correlation between the lymphatic and SC-blood concentrations was noted.


(1) a significant release of TNFα was not observed in our study. (2) The high concentrations of Troponin I in cardiac lymph indicate a myocardial cell damage during CPB which is strongly underestimate by Sinus Coronarius blood samples.

Authors’ Affiliations

Department of Thoracic- and Cardiovascular Surgery, and Department of Pediatric Cardiology, Aachen University of Technology, Aachen, Germany


© Current Science Ltd 1999