Kamiya Hiroyuki, Watanabe Go, Doi Toshio, Saito Taro, Takahashi Masao, Tomita Shigeyuki, Tsukioka Toshihide, Kanamori Taro
Department of Surgery I, Kanazawa University School of Medicine, Japan.
Ann Thorac Cardiovasc Surg. 2003 Apr;9(2):117-22.
We developed a coronary active perfusion system (CAPS) to avoid myocardial ischemia during off-pump coronary artery bypass (OPCAB). The purpose of this study was to determine the optimal timing of CAPS perfusion, and to investigate any adverse effects when it is driven within the systolic phase. Twenty-four pigs were divided into four groups: (A) systolic, (B) early-diastolic, (C) middle-diastolic, and (D) late-diastolic perfusion. Myocardial blood flow (MBF), hemodynamic and mechanical data were measured during 30 minutes of CAPS perfusion. MBF in group A was lower than in the other groups (p<0.001), but no significant differences were observed among groups B to D. End-systolic pressure-volume relation (Mw) and preload recruitable stroke work relation (Ees) in group A was lower than in groups B to D (p<0.01 and p<0.05, respectively), but no significant differences were observed among groups B to D. CAPS could maintain regional MBF and left ventricular function if it was driven only within the diastolic phase and required no strict adjustment, but CAPS has an adverse effect when it is driven in the systolic phase.
我们研发了一种冠状动脉主动灌注系统（CAPS），以避免非体外循环冠状动脉搭桥术（OPCAB）期间的心肌缺血。本研究的目的是确定CAPS灌注的最佳时机，并研究在收缩期驱动该系统时是否存在任何不良影响。将24头猪分为四组：（A）收缩期灌注组、（B）舒张早期灌注组、（C）舒张中期灌注组和（D）舒张晚期灌注组。在CAPS灌注30分钟期间测量心肌血流量（MBF）、血流动力学和力学数据。A组的MBF低于其他组（p<0.001），但B组至D组之间未观察到显著差异。A组的收缩末期压力-容积关系（Mw）和可招募前负荷搏功关系（Ees）低于B组至D组（分别为p<0.01和p<0.05），但B组至D组之间未观察到显著差异。如果仅在舒张期驱动，CAPS可以维持局部MBF和左心室功能，且无需严格调整，但在收缩期驱动时，CAPS会产生不良影响。
