Salhiyyah Kareem, Raja Shahzad G, Akeela Hiba, Pepper John, Amrani Mohamed
Department of Cardiothoracic Surgery, Harefield Hospital, Royal Brompton & Harefield NHS Trust, Hill End Road, Harefield, London, UB9 6JH, UK.
Future Cardiol. 2010 Nov;6(6):845-58. doi: 10.2217/fca.10.102.
Prior to the introduction of cardioplegia, beating heart continuous coronary perfusion (BHCCP) was the only available method of myocardial protection. Currently, cardiac surgery on cardiopulmonary bypass with cardioplegic arrest is the gold standard strategy. Cardioplegic arrest provides an easier and safer way to operate on a still heart. It enables the performance of a broader range of cardiac procedures, and avoids the potential difficulties of continuous perfusion on a beating heart. Despite the overall effectiveness and safety of cardioplegia, some adverse effects remain, mainly due to the insult of ischemia, which results in ischemic reperfusion injury. As a result BHCCP has seen a revival as an alternative to cardioplegia for performing complex valvular surgery. Increasing experience reporting safety and efficacy of BHCCP is being published. However, despite the reported advantages, current available evidence validating safety and efficacy of BHCCP is controversial. This article provides an overview of BHCCP highlighting the current best available evidence supporting this strategy, concerns, controversies and potential areas for further research.
在心脏停搏液引入之前，心脏不停跳持续冠状动脉灌注（BHCCP）是唯一可用的心肌保护方法。目前，在体外循环下进行心脏停搏液停搏的心脏手术是金标准策略。心脏停搏液停搏为在静止的心脏上进行手术提供了一种更简便、更安全的方法。它能够开展更广泛的心脏手术，并避免了在跳动的心脏上进行持续灌注的潜在困难。尽管心脏停搏液总体有效且安全，但仍存在一些不良反应，主要是由于缺血损伤，这会导致缺血再灌注损伤。因此，BHCCP作为心脏停搏液的替代方法用于进行复杂瓣膜手术又重新受到关注。越来越多关于BHCCP安全性和有效性的经验报告正在发表。然而，尽管有报道称其具有优势，但目前证实BHCCP安全性和有效性的现有证据仍存在争议。本文概述了BHCCP，重点介绍了支持该策略的当前最佳现有证据、关注点、争议点以及进一步研究的潜在领域。
