Katircioglu S F, Gökçe P, Ulus A T, Tütün U, Apaydin N, Koç B
Cardiovascular Surgery Department, Turkiye Yüksek Ihtisas Hospital and Veterinary Faculty of Ankara University, Ankara, Turkey.
Int J Cardiol. 2000 Apr 28;73(2):115-21. doi: 10.1016/s0167-5273(99)00213-2.
This study examined if the use of simplified coronary sinus retroperfusion would lead to any reduction in the infarcted area associated with improved right and left ventricular function. Twelve mongrel dogs were entered in this study. Following anesthesia, a fast response thermistor was placed on the pulmonary artery via the jugular vein and aorta via the left ventricular apex. The left anterior descending artery (LAD) was separated from the vein. A retrograde cardioplegia catheter was inserted into the coronary sinus. Following these procedures, LAD was occluded for a period of 3.5 h. After 30 min ischemia, the aorta-coronary sinus connection was established. The animals were divided into two equal groups. One group was not treated and was considered the control group (six animals). In the remaining group (six animals), retroperfusion was used and was considered the retroperfusion group. At the end of the study, the left ventricular ejection fraction was 65+/-15% in the retroperfusion group and 48+/-5% in the control group (P<0.05). The left ventricular stroke work index was 0.44+/-0.04 (g m/kg) in the retroperfusion group and 0.31+/-0.05 (g m/kg) in the control group (P<0.05). Cardiac output was 1650+/-75 ml/min in the retroperfusion group and 1250+/-125 ml/min in the control group. The ratio of the infarct size to the area at risk was 49+/-5% in the control group and 7+/-3% in the retroperfusion group. In light of these studies, we conclude that simplified coronary sinus retroperfusion appears to be an effective method that must be taken into consideration.
本研究旨在探讨使用简化冠状静脉窦逆行灌注是否会使梗死面积减小，并改善左右心室功能。12只杂种犬纳入本研究。麻醉后，通过颈静脉将快速响应热敏电阻置于肺动脉，通过左心室尖将其置于主动脉。分离左前降支动脉与静脉。将逆行心脏停搏导管插入冠状静脉窦。完成这些操作后，左前降支动脉闭塞3.5小时。缺血30分钟后，建立主动脉-冠状静脉窦连接。动物被分为两组，每组6只。一组不进行处理，作为对照组；另一组进行逆行灌注，作为逆行灌注组。研究结束时，逆行灌注组左心室射血分数为65±15%，对照组为48±5%（P<0.05）。逆行灌注组左心室每搏功指数为0.44±0.04（g m/kg），对照组为0.31±0.05（g m/kg）（P<0.05）。逆行灌注组心输出量为1650±75 ml/min，对照组为1250±125 ml/min。对照组梗死面积与危险面积之比为49±5%，逆行灌注组为7±3%。基于这些研究，我们得出结论，简化冠状静脉窦逆行灌注似乎是一种必须考虑的有效方法。
