微创主动脉瓣手术中的Del Nido心脏停搏液
Del Nido cardioplegia in the setting of minimally invasive aortic valve surgery.
作者信息
Vistarini Nicola, Laliberté Eric, Beauchamp Philippe, Bouhout Ismail, Lamarche Yoan, Cartier Raymond, Carrier Michel, Perrault Louis, Bouchard Denis, El-Hamamsy Ismaïl, Pellerin Michel, Demers Philippe
机构信息
1 Department of Cardiac Surgery, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada.
2 Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Pavia University School of Medicine, Pavaia, Italy.
出版信息
Perfusion. 2017 Mar;32(2):112-117. doi: 10.1177/0267659116662701. Epub 2016 Jul 28.
The purpose of this study is to report our experience with del Nido cardioplegia (DNC) in the setting of minimally invasive aortic valve surgery. Forty-six consecutive patients underwent minimally invasive aortic valve replacement (AVR) through a "J" ministernotomy: twenty-five patients received the DNC (Group 1) and 21 patients received standard blood cardioplegia (SBC) (Group 2). The rate of ventricular fibrillation at unclamping was significantly lower in the DNC group (12% vs 52%, p=0.004), as well as postoperative creatinine kinase-MB (CK-MB) values (11.4±5.2 vs 17.7±6.9 µg/L, p=0.004). There were no deaths, myocardial infarctions or major complications in either group. Less postoperative use of intravenous insulin (28% vs 81%, p<0.001) was registered in the DNC group. In conclusion, the DNC is easy to use and safe during minimally invasive AVR, providing a myocardial protection at least equivalent to our SBC, improved surgical efficiency, minimal cost and less blood glucose perturbations.
本研究的目的是报告我们在微创主动脉瓣手术中使用德尔尼多停搏液（DNC）的经验。46例连续患者通过“J”形小切口胸骨切开术接受了微创主动脉瓣置换术（AVR）：25例患者接受了DNC（第1组），21例患者接受了标准血液停搏液（SBC）（第2组）。在松开主动脉阻断钳时，DNC组的心室颤动发生率显著更低（12% 对52%，p = 0.004），术后肌酸激酶-MB（CK-MB）值也是如此（11.4±5.2对17.7±6.9µg/L，p = 0.004）。两组均无死亡、心肌梗死或重大并发症。DNC组术后静脉胰岛素的使用更少（28% 对81%，p<0.001）。总之，在微创AVR期间，DNC易于使用且安全，提供的心肌保护至少等同于我们的SBC，提高了手术效率，成本最低且血糖波动更小。
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