Kazama S, Nishiyama K, Imai H, Machii M, Sonoda K, Ishihara A
Kyobu Geka. 1989 Jul;42(7):537-40.
In this study we intended to clarify the benefits of left ventricular venting by comparing the surgical results and clinical courses of 19 adult patients who underwent open heart procedures with venting and those of 44 adult patients who had open heart procedures without venting. All of the patients of both groups underwent operations for acquired heart diseases. The hospital mortality was 10.5% in the vent group and 2.3% in the no-vent group (NS). None of the deaths occurred due to the postoperative low output syndrome in either group. The incidence of spontaneous defibrillation was not different in the two groups, and no patients required postoperative IABP support in either group. The number of patients who needed catecholamine infusion for longer than 24 hours postoperatively were not statistically different in the two groups, and incidence of ventricular arrhythmias was not different in the two groups. The cardiac index determined 6 hours postoperatively was significantly higher in the no-vent group. The left atrial pressure in the no-vent group did not exceed 10 mmHg during cardiopulmonary bypass, if the central venous pressure was maintained below 7 mmHg. It was suggested that distension of the left ventricle and myocardial injuries do not occur during cardiopulmonary bypass without left ventricular venting, provided the central venous pressure is maintained below 6 or 7 mmHg.
在本研究中，我们旨在通过比较19例接受心脏直视手术并进行左心室排气的成年患者与44例接受心脏直视手术但未进行排气的成年患者的手术结果和临床病程，来阐明左心室排气的益处。两组所有患者均接受了后天性心脏病手术。排气组的医院死亡率为10.5%，未排气组为2.3%（无统计学差异）。两组均无因术后低心排血量综合征导致的死亡。两组的自发除颤发生率无差异，两组均无患者需要术后主动脉内球囊反搏支持。两组术后需要使用儿茶酚胺超过24小时的患者数量无统计学差异，两组室性心律失常的发生率也无差异。术后6小时测定的心脏指数在未排气组显著更高。如果中心静脉压维持在7 mmHg以下，未排气组在体外循环期间左心房压力不超过10 mmHg。研究表明，如果中心静脉压维持在6或7 mmHg以下，在不进行左心室排气的体外循环期间不会发生左心室扩张和心肌损伤。
