Issitt R W, Robertson D A, Crook R M, Cross N T, Shaw M, Tsang V T
Department of Clinical Perfusion, Great Ormond Street Hospital, London, UK Institute of Cardiovascular Science, University College London, UK
Department of Clinical Perfusion, Great Ormond Street Hospital, London, UK.
Perfusion. 2014 Nov;29(6):567-70. doi: 10.1177/0267659114540019. Epub 2014 Jun 19.
Major aortopulmonary collateral arteries (MAPCAs) provide significant issues during cardiopulmonary bypass, including flooding of the surgical field which requires significant blood volumes to be returned to the extracorporeal circuit via handheld suckers. This has been shown to be the major source of gaseous microemboli and is associated with adverse neurological outcome. Use of pH-stat has been previously shown to decrease the shunt through MAPCAs via an unknown mechanism. Here, we report the associated benefits of pH-stat in decreasing sucker usage and gaseous microemboli in a patient with known MAPCAs presenting for repair of tetralogy of Fallot and pulmonary atresia.
主要的体肺侧支动脉（MAPCAs）在体外循环期间会引发重大问题，包括手术视野被淹没，这需要通过手持吸引器将大量血液回输到体外循环中。这已被证明是气态微栓子的主要来源，并与不良神经学后果相关。先前的研究表明，使用pH稳态法可通过未知机制减少经MAPCAs的分流。在此，我们报告了pH稳态法在一名因法洛四联症和肺动脉闭锁前来接受修复手术且已知存在MAPCAs的患者中，在减少吸引器使用和气态微栓子方面的相关益处。
