Salerno T A, Houck J P, Barrozo C A, Panos A, Christakis G T, Abel J G, Lichtenstein S V
Division of Cardiovascular Surgery, St. Michael's Hospital, University of Toronto, Ontario, Canada.
Ann Thorac Surg. 1991 Feb;51(2):245-7. doi: 10.1016/0003-4975(91)90795-r.
This report presents the results in our first clinical series of patients receiving continuous warm blood cardioplegia through the coronary sinus. Warm oxygenated blood cardioplegia has certain theoretical advantages, such as continuously supplying oxygen and substrates to the arrested heart while avoiding the side effects of hypothermia. Retrograde infusion of cardioplegia also offers certain advantages (eg, in valve operations and in patients with severe coronary artery disease) that are complementary to warm blood cardioplegia. Retrograde warm blood cardioplegia was used in 113 consecutive patients (85 men and 28 women with a mean age of 61 years) undergoing various procedures. Three percent of the patients died, 7% needed transient intraaortic balloon pump support, 6% had evidence of perioperative myocardial infarction, and 96% had spontaneous return of rhythm. There were no coronary sinus injuries. This new technique of retrograde continuous warm blood cardioplegia is a simple, safe, and reliable method of myocardial protection that may change the way we currently protect the heart intraoperatively.
本报告展示了我们首个临床系列中通过冠状窦接受持续温血心脏停搏液灌注的患者的结果。温氧合血心脏停搏液具有一定的理论优势，比如在心脏停搏时持续为其供应氧气和底物，同时避免低温带来的副作用。逆行灌注心脏停搏液也具有某些优势（如在瓣膜手术和严重冠状动脉疾病患者中），这与温血心脏停搏液互为补充。113例连续接受各种手术的患者（85例男性和28例女性，平均年龄61岁）采用了逆行温血心脏停搏液。3%的患者死亡，7%的患者需要短期主动脉内球囊泵支持，6%的患者有围手术期心肌梗死迹象，96%的患者心律自发恢复。未发生冠状窦损伤。这种逆行持续温血心脏停搏新技术是一种简单、安全且可靠的心肌保护方法，可能会改变我们目前术中保护心脏的方式。
