Martinez-Leon J, Carbonell-Canti C, Ortega-Serrano J
Department of Surgery, Clinical Hospital, University of Valencia, Spain.
Scand J Thorac Cardiovasc Surg. 1992;26(3):207-12. doi: 10.3109/14017439209099079.
To investigate retrograde delivery of cardioplegic solutions as a means of enhancing myocardial protection in the presence of coronary artery occlusion, a two-part experimental model was devised. In part 1 (in vitro) the possibility of retroperfusing the entire myocardium during acute occlusion of the left anterior descending artery (LAD) was assessed. In part 2 (in vivo) acute LAD occlusion was performed in dogs, and during 2 hours of aortic cross-clamping crystalline cardioplegic solution was infused at 20-minute intervals. In group I the infusion was antegrade, via the aortic root, and in group II it was retrograde, via the coronary sinus. Thereafter the LAD snare was released and the dogs were weaned from bypass. Delivery of cardioplegia through the aortic root was associated with depression of ventricular function, poor myocardial cooling and severe cellular damage. With the retrograde procedure there was significantly improved recovery of left ventricular function, uniform myocardial cooling and better preservation of cellular morphology.
为了研究在冠状动脉闭塞情况下，通过逆行灌注心脏停搏液来增强心肌保护作用的方法，设计了一个分为两部分的实验模型。在第一部分（体外实验）中，评估了在左冠状动脉前降支（LAD）急性闭塞期间对整个心肌进行逆行灌注的可能性。在第二部分（体内实验）中，对犬进行LAD急性闭塞，并在主动脉阻断2小时期间，每隔20分钟输注晶体心脏停搏液。在第一组中，通过主动脉根部顺行输注，在第二组中，通过冠状静脉窦逆行输注。此后，松开LAD圈套器，使犬脱离体外循环。通过主动脉根部进行心脏停搏液灌注与心室功能抑制、心肌降温不佳及严重的细胞损伤有关。采用逆行灌注方法时，左心室功能的恢复明显改善，心肌均匀降温，细胞形态得到更好的保存。
