Effects of calcium on the coronary and systemic circulation in patients after coronary surgery.

Abstract

Nine patients were studied three hours after aorto-coronary bypass. Before anaesthesia a radial arterial cannula was inserted and a thermodilution catheter placed into the pulmonary artery by fluoroscopy. A special thermodilution catheter was manipulated into the coronary sinus. Haemodynamic measurements were made plus cardiac output and coronary sinus blood flow. Content of oxygen and lactate in arterial and coronary sinus blood was determined. Series of measurements were done before and after 1 gm of CaCl2 given intravenously over 15 minutes. Calcium increased cardiac index and arterial pressure but not systemic vascular resistance. Total coronary sinus blood flow did not change, nor did myocardial oxygen consumption or coronary sinus oxygen content. Content of lactate in arterial and coronary sinus blood was unaltered and lactate extraction by the heart continued, in eight of nine patients. The improved haemodynamics were accomplished without inordinate risk to global ventricular energy metabolism.