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单中心关于Cardioplexol™心肌保护液与微创体外循环联合用于单纯冠状动脉搭桥手术的经验。

Single-center experience with the combination of Cardioplexol™ cardioplegia and MiECC for isolated coronary artery bypass graft procedures.

作者信息

Tevaeara Stahel Hendrik, Barandun Silvio, Kaufmann Emilie, Gahl Brigitta, Englberger Lars, Jenni Hansjoerg, Weber Alberto, Aymard Thierry, Gygax Erich, Carrel Thierry

机构信息

Swiss Cardio Technologies, Stansstad, Switzerland.

Department of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

出版信息

J Thorac Dis. 2019 Jun;11(Suppl 10):S1471-S1479. doi: 10.21037/jtd.2019.04.47.

Abstract

BACKGROUND

Cardioplexol™ with its low volume (100 mL) was originally conceived as cardioplegic solution for MiECC procedures. Introduced in its current form in 2008 in our clinic, it has immediately demonstrated attractive advantages including the easy and rapid administration by the surgeon him/herself, the almost immediate cardiac arrest and a prolonged delay before a second dose is necessary. We report here the results of our initial experience with this simple solution.

METHODS

Single centre, retrospective observational analysis of prospectively collected data of isolated coronary artery bypass graft (CABG) procedures performed with a MiECC.

RESULTS

Of 7,447 adult cardiac surgical operations performed during a 76 months period, 2,416 were isolated CABG-MiECC procedures. Patients were 81.3% males, 66.2±9.7 years old and had a median logistic EuroSCORE of 3.2. In average 3.2±0.8 vessels were bypassed. Median cross-clamp time was 45 minutes and more than 75% of the patients received only one 100 mL dose of Cardioplexol™. At reperfusion more than 90% of the hearts spontaneously recovered a rhythmic activity. Maximal value of troponin T during the first hours following myocardial reperfusion was 0.9±4.5 ng/mL (median =0.4 ng/mL). Mortality at 30 days was 0.9%.

CONCLUSIONS

Cardioplexol™ seems very promising. It appears especially efficient and safe when used for CABG procedures performed with a MiECC.

摘要

背景

Cardioplexol™容量小(100毫升),最初被设计为用于微创体外循环(MiECC)手术的心脏停搏液。2008年以其目前的形式在我们诊所推出后,它立即展现出诱人的优势,包括外科医生可轻松快速给药、几乎能立即实现心脏停搏以及在需要第二剂之前有较长的延迟时间。我们在此报告我们对这种简单溶液的初步经验结果。

方法

对前瞻性收集的使用MiECC进行的孤立冠状动脉搭桥术(CABG)手术数据进行单中心回顾性观察分析。

结果

在76个月期间进行的7447例成人心脏手术中,2416例为孤立CABG - MiECC手术。患者中男性占81.3%,年龄为66.2±9.7岁,逻辑EuroSCORE中位数为3.2。平均搭桥3.2±0.8支血管。中位夹闭时间为45分钟,超过75%的患者仅接受一剂100毫升的Cardioplexol™。再灌注时,超过90%的心脏自发恢复节律性活动。心肌再灌注后最初几小时内肌钙蛋白T的最大值为0.9±4.5纳克/毫升(中位数 = 0.4纳克/毫升)。30天死亡率为0.9%。

结论

Cardioplexol™似乎很有前景。当用于MiECC进行的CABG手术时,它显得特别有效且安全。

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