Chen Y F, Chen J S, Wang J R, Chiu C C, Lin Y T
Department of Surgery, Kaohsiung Medical College, Taiwan.
Eur J Cardiothorac Surg. 1990;4(11):618-23. doi: 10.1016/1010-7940(90)90022-r.
During the development of methods to protect the heart from ischaemic injury, attention has been focused on protection of the left ventricle. In an attempt to assess right heart preservation. 55 consecutive patients undergoing open heart surgery were studied. Mean aortic cross-clamp time was 59.3 +/- 29.4 min. Temperature probes were inserted into the right atrium (RA), right ventricle (RV), and left ventricle (LV). During cardioplegia, the mean myocardial temperatures of RA, RV and LV were 19.1 degrees +/- 4.1 degrees C, 12.7 degrees +/- 4.8 degrees C and 7.3 degrees +/- 3.4 degrees C, respectively. Of the LV temperature measurements, 67.2% were 10 degrees C or lower. By contrast, 94.1% of RA measurements and 58.5% of RV measurements were above 10 degrees C. The inhomogeneity of chamber temperatures was observed irrespective of the patient's disease or age and whether the atrium or right ventricle were open or not. Hearts with mitral regurgitation (MR), in contrast to mitral stenosis and stenoinsufficiency, had higher LV temperatures, similar to those in the RV. We conclude that there is uneven hypothermia among the three cardiac chambers during hypothermic cardioplegic arrest, regardless of disease states except MR and regardless of age and procedure performed.
在研发保护心脏免受缺血性损伤的方法过程中，注意力一直集中在左心室的保护上。为了评估右心保护情况，对55例连续接受心脏直视手术的患者进行了研究。平均主动脉阻断时间为59.3±29.4分钟。温度探头插入右心房（RA）、右心室（RV）和左心室（LV）。在心脏停搏期间，RA、RV和LV的平均心肌温度分别为19.1℃±4.1℃、12.7℃±4.8℃和7.3℃±3.4℃。在LV温度测量中，67.2%为10℃或更低。相比之下，94.1%的RA测量值和58.5%的RV测量值高于10℃。无论患者的疾病或年龄以及心房或右心室是否开放，均观察到心腔温度的不均匀性。与二尖瓣狭窄和狭窄关闭不全相比，二尖瓣反流（MR）患者的LV温度较高，与RV相似。我们得出结论，在低温心脏停搏期间，除MR外，无论疾病状态、年龄和手术操作如何，三个心腔之间存在不均匀的低温情况。
