Fiore A C, Naunheim K S, Kaiser G C, Willman V L, McBride L R, Pennington D G, Barner H B
Department of Surgery, St. Louis University Medical Center, MO 63110-0250.
Ann Thorac Surg. 1989 May;47(5):684-8. doi: 10.1016/0003-4975(89)90118-5.
The role of retrograde coronary sinus cardioplegia in patients undergoing elective coronary artery bypass grafting has not been fully defined. Forty patients undergoing coronary artery bypass grafting received either aortic root (20 patients) or coronary sinus (20 patients) cold potassium blood cardioplegia. The patients were similar with respect to age, ventricular function, severity of coronary artery disease, cross-clamp time, completeness of revascularization, frequency of internal mammary artery grafting, and mean infusate volume and temperature. The time required to deliver the initial dose of cardioplegic solution and the time to achieve arrest were prolonged in the coronary sinus group (p less than 0.001 and p less than 0.02, respectively). There were no differences between the two groups postoperatively with regard to enzymatic indices, hemodynamic measurement, or clinical outcome. Right ventricular function was preserved equally in both groups. We conclude that coronary sinus cardioplegia is a safe alternative to aortic root perfusion, but offers no advantage in elective myocardial revascularization.
逆行冠状静脉窦停搏在择期冠状动脉旁路移植术患者中的作用尚未完全明确。40例行冠状动脉旁路移植术的患者分别接受了主动脉根部（20例患者）或冠状静脉窦（20例患者）冷钾血停搏液灌注。患者在年龄、心室功能、冠状动脉疾病严重程度、主动脉阻断时间、血运重建完整性、乳内动脉移植频率以及平均灌注液量和温度方面相似。冠状静脉窦组给予初始剂量停搏液所需时间和达到心脏停搏的时间延长（分别为p<0.001和p<0.02）。两组术后在酶学指标、血流动力学测量或临床结局方面无差异。两组右心室功能均得到同等程度的保留。我们得出结论，冠状静脉窦停搏是主动脉根部灌注的一种安全替代方法，但在择期心肌血运重建中并无优势。
