Cicekcioglu Ferit, Tutun Ufuk, Babaroglu Seyhan, Aksoyek Aysen, Parlar Ali Ihsan, Mungan Ufuk, Tosya Alper, Tuncel Cagatay, Demirtas Ertan, Katircioglu Salih Fehmi
Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey.
J Card Surg. 2007 May-Jun;22(3):211-4. doi: 10.1111/j.1540-8191.2007.00387.x.
The aim of this study was to assess the efficacy and applicability of on-pump beating heart aortic valve replacement with retrograde coronary sinus (CS) warm blood perfusion.
The prospective study included 14 consecutive patients who underwent aortic valve replacement with mechanical prosthesis using retrograde CS perfusion. The operative variables and early outcome of this procedure are presented.
Retrograde CS perfusion and venting the heart from the pulmonary vein provided good visualization of the operative field and performance of the operations without any difficulty. Partial oxygen pressures of CS perfusion blood and the returning blood from the coronary ostia were 288.5 +/- 34.4 and 39.6 +/- 4.6 mmHg, respectively. Postoperative peak creatine kinase-MB and troponin T values were mean 77.0 +/- 63.6 IU/L and mean 0.8 +/- 0.7 ng/mL, respectively. No mortality or major complication was observed and all the patients were discharged from the hospital in good condition.
On-pump beating heart aortic valve replacement with retrograde CS warm blood perfusion is a good surgical option, and has the advantage of maintaining physiologic condition of the heart throughout the procedure.
本研究旨在评估采用逆行冠状静脉窦（CS）温血灌注的体外循环下心脏跳动中主动脉瓣置换术的疗效及适用性。
这项前瞻性研究纳入了连续14例行机械瓣主动脉瓣置换术并采用逆行CS灌注的患者。文中呈现了该手术的操作变量及早期结果。
逆行CS灌注及经肺静脉排出心脏内气体可提供良好的术野视野，手术操作顺利。CS灌注血及冠状动脉开口回流血液的部分氧分压分别为288.5±34.4 mmHg和39.6±4.6 mmHg。术后肌酸激酶同工酶（CK-MB）峰值及肌钙蛋白T值分别平均为77.0±63.6 IU/L和平均0.8±0.7 ng/mL。未观察到死亡或严重并发症，所有患者均康复出院。
采用逆行CS温血灌注的体外循环下心脏跳动中主动脉瓣置换术是一种良好的手术选择，具有在整个手术过程中维持心脏生理状态的优势。
