Mulder D G, Olinger G N, McConnell D H, Maloney J V, Buckberg G D
Ann Thorac Surg. 1976 Feb;21(2):123-30. doi: 10.1016/s0003-4975(10)64274-9.
The results following aortic valve replacement (AVR) were compared in 40 patients in whom the myocardium was protected by topical hypothermic arrest or continuous coronary perfusion with sustained electrical fibrillation (Group A) and 40 similar patients in whom the hearts were also continuously perfused but were kept in the beating state (Group B). The operative mortality was not greatly different between the two groups, being 10 and 5%, respectively. The postperfusion cardiac performance was strikingly different, however. Seventeen patients (43%) in Group A required inotropic support, while this was necessary in only 1 patient (3%) in Group B. In this instance, recurrent ventricular fibrillation persisted despite attempts at reversion. These data show that the myocardium is preserved best during AVR when continuous coronary perfusion is used and the heart is maintained in the beating state.
对40例采用局部低温停搏或持续冠状动脉灌注并维持心室颤动来保护心肌的患者（A组）和40例同样进行持续灌注但心脏保持跳动状态的类似患者（B组）进行主动脉瓣置换（AVR）后的结果比较。两组的手术死亡率差异不大，分别为10%和5%。然而，灌注后心脏功能有显著差异。A组有17例患者（43%）需要使用正性肌力药物支持，而B组仅1例患者（3%）有此需求。在这种情况下，尽管尝试复律，但室颤仍反复发作。这些数据表明，在主动脉瓣置换术中，当采用持续冠状动脉灌注并使心脏保持跳动状态时，心肌能得到最佳保护。
