Yajima T, Ikeshita M, Shoji T
Second Department of Surgery, Nippon Medical School, Tokyo, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Dec;38(12):2409-15.
Among various methods to treat ventricular tachyarrhythmia (VT) in the presence of acute myocardial infraction, the surgical approach is a somewhat unsatisfactory method in case of preoperative acute hemodynamic deterioration. The transatrial approach with the "topical" application of Lugol solution on left ventricular (LV) endocardium, without left ventriculotomy, i.e. a transatrial chemical ablation method; has been reported in our department as suggestive to being efficacious. The objective of the present study is to investigate the occurrence of left bundle branch block (LBBB) and the like, as well as to examine the impact on heart function, particularly LV function, by employing the just-above mentioned approach. 15 mongrel dogs were being experimented on. Through a left transatrial approach toward LV endocardium and the application of Lugol solution, with pulmonary artery flow being as constant; we measured pre- and post-operative left atrial (LA) pressure, LV pressure, aortic pressure, LV functional shortening, and stroke volume. In addition, the same protocol was also employed in another group, with the application of physiologic normal saline solution, instead. A comparative study was made between the two groups. In the Lugol solution group, postoperative LA pressure and LVEDP showed a tendency toward exhibiting higher values, when compared to preoperative readings. However, no significant difference was observed in this setting. Furthermore, in comparison with postoperative readings in the saline group, the mean LA pressure in the Lugol solution group exhibited a tendency toward somewhat higher values. Nonetheless, no significant difference was observed in LV functional shortening between the two groups; though it is known a LBB pattern could be noticed on ECG in the Lugol solution group.(ABSTRACT TRUNCATED AT 250 WORDS)
在治疗急性心肌梗死时出现的室性快速心律失常(VT)的各种方法中,手术方法在术前急性血流动力学恶化的情况下是一种不太令人满意的方法。经心房途径,在不进行左心室切开术的情况下,将卢戈氏溶液“局部”应用于左心室(LV)心内膜,即经心房化学消融法;据我科报道,这种方法似乎有效。本研究的目的是调查左束支传导阻滞(LBBB)等情况的发生,并通过采用上述方法检查对心脏功能,特别是左心室功能的影响。对15只杂种狗进行了实验。通过经左心房途径到达左心室心内膜并应用卢戈氏溶液,同时保持肺动脉血流恒定;我们测量了术前和术后的左心房(LA)压力、左心室压力、主动脉压力、左心室功能缩短率和每搏输出量。此外,另一组采用相同方案,但应用生理生理盐水溶液。对两组进行了比较研究。在卢戈氏溶液组中,与术前读数相比,术后LA压力和左心室舒张末期压力(LVEDP)有升高的趋势。然而,在这种情况下未观察到显著差异。此外,与生理盐水组的术后读数相比,卢戈氏溶液组的平均LA压力有略高的趋势。尽管如此,两组之间的左心室功能缩短率没有显著差异;尽管已知在卢戈氏溶液组的心电图上可以观察到LBB模式。(摘要截断于250字)