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[热成像技术在缺血性心脏病外科治疗中的应用经验]

[Experiences with thermography in the surgical treatment of ischemic heart disease].

作者信息

Szabó Z, Papp L

出版信息

Herz. 1986 Aug;11(4):226-31.

PMID:3489658
Abstract

Possible use of thermography (AGA Thermovision 750) in heart surgery has been investigated in animal experiments and in human extracorporeal operations as well. In six open-chest isolated dog hearts, coronary circulation had been occluded and antero- and retrograde local cooling was employed. Following coronary occlusion, effective hypothermia was achieved retrograde via the coronary sinus. 22 patients were arranged into three groups according to the operation technique used, and the possibilities for effective cardiac cooling by cold cardioplegic solution were studied. Hearts of the six patients subjected to surgical intervention for valvular lesions (four mitral and two aortic) could be safely cooled by cold cardioplegic solution infused through the aorta or the coronary arteries. The hearts of the twelve patients with coronary artery stenosis could be cooled sufficiently by additional retrograde infusion only. Employing antero- and retrograde hypothermia, in four patients the size of the aneurysm of the left ventricle, and the area which had to be resected was determined by thermography. Thermography is considered to be a suitable non-invasive method to derive information concerning: the efficacy of cold cardioplegic solution in aortocoronary bypass grafting, quantitative changes in nutritive coronary flow, the size of left ventricular aneurysmectomy.

摘要

在动物实验和人体体外手术中,都对热成像技术(AGA Thermovision 750)在心脏手术中的潜在应用进行了研究。在六只开胸的离体犬心脏中,阻断冠状动脉循环,并采用顺行和逆行局部降温。冠状动脉阻断后,通过冠状窦逆行实现了有效的低温。根据所采用的手术技术,将22例患者分为三组,研究了冷心脏停搏液有效心脏降温的可能性。接受瓣膜病变手术干预的6例患者(4例二尖瓣病变和2例主动脉瓣病变)的心脏,可通过经主动脉或冠状动脉注入冷心脏停搏液安全降温。12例冠状动脉狭窄患者的心脏仅通过额外的逆行灌注就可充分降温。采用顺行和逆行低温,通过热成像确定了4例患者左心室动脉瘤的大小以及必须切除的区域。热成像被认为是一种合适的非侵入性方法,可用于获取以下信息:冷心脏停搏液在主动脉冠状动脉旁路移植术中的效果、营养性冠状动脉血流的定量变化、左心室动脉瘤切除术的大小。

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