微创二尖瓣手术中的心肌保护：策略和心脏停搏液解决方案。
Myocardial protection during minimally invasive mitral valve surgery: strategies and cardioplegic solutions.
机构信息
Department of Cardiac Surgery, Heart Center, University of Leipzig, Germany.
出版信息
Ann Cardiothorac Surg. 2013 Nov;2(6):803-8. doi: 10.3978/j.issn.2225-319X.2013.09.04.
Abstract
Effective myocardial protection and perfusion strategies during minimally invasive mitral valve surgery (Mini-MV) have evolved over the last decade. Our institutional approach for right-sided Mini-MV has been standardized over the last 15 years in more than 4,500 cases. Cardiopulmonary bypass (CPB) is usually instituted by right-sided femoral arterial and venous cannulation with additional cannulation of the right jugular vein in patients with a body weight greater than 75 kg or when a concomitant tricuspid valve (TV) procedure and/or atrial septal defect closure is performed. A single dosage of crystalloid-based cardioplegia [Custodial- histidine-trypthophan-ketoglutarate (Custodial-HTK)] administered via the aortic root in combination with moderate hypothermia (34-35 °C) has become the standard of care for induction and maintenance of myocardial protection at our institution. The present article highlights and discusses the principal techniques of myocardial protection for Mini-MV.
摘要
在微创二尖瓣手术（Mini-MV）期间，有效的心肌保护和灌注策略在过去十年中不断发展。我们机构的右侧微创二尖瓣手术方法在过去 15 年中在超过 4500 例病例中得到了标准化。体外循环（CPB）通常通过右侧股动脉和静脉插管以及体重超过 75 公斤的患者的右侧颈静脉插管或同时进行三尖瓣（TV）手术和/或房间隔缺损关闭来建立。通过主动脉根部给予单次剂量基于晶体的心脏停搏液[Custodial-组氨酸-色氨酸-酮戊二酸（Custodial-HTK）]，并结合中度低温（34-35°C），已成为我们机构诱导和维持心肌保护的标准护理。本文重点介绍和讨论了微创二尖瓣手术中心肌保护的主要技术。
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本文引用的文献
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Circulation. 2013 Jul 30;128(5):483-91. doi: 10.1161/CIRCULATIONAHA.112.001402. Epub 2013 Jun 26.
2
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Eur J Cardiothorac Surg. 2013 Jul;44(1):e1-7. doi: 10.1093/ejcts/ezt144. Epub 2013 Mar 21.
3
Mitral valve surgical procedures in the elderly.老年二尖瓣手术。
Ann Thorac Surg. 2012 Dec;94(6):1999-2003. doi: 10.1016/j.athoracsur.2012.05.069. Epub 2012 Jul 25.
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J Cardiothorac Surg. 2012 Jun 10;7:52. doi: 10.1186/1749-8090-7-52.
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