[Emergency craniocerebral hypothermia in the management of open mitral commissurotomy].

Craniocerebral hypothermia was used during open-heart surgery in 69 patients with mitral stenosis (hospital mortality rate 2.9%). Indications for open-heart surgery (left atrial thrombosis, mitral valve calcinosis, onset of traumatic mitral insufficiency) were determined intraoperatively during closed mitral commissurotomy. Some pathophysiological peculiarities of craniocerebral hypothermia were studied. A decrease in brain temperature and total oxygen consumption (up to 27.7% of the basic metabolism level) has been observed. Prolongation (up to 25 min) of major vessel occlusion had no negative effect on the patients' condition, postoperative complications and lethality. Craniocerebral hypothermia is considered to be a safe and effective technique indicated in case of emergency for open-heart surgery.