Horneffer P J, Gott V L, Gardner T J
Ann Thorac Surg. 1986 Aug;42(2):139-42. doi: 10.1016/s0003-4975(10)60506-1.
To determine whether continuous infusion of cardioplegia retrograde through the coronary sinus could improve the salvage of infarcting myocardium, 54 pigs were utilized in a region at risk model. All hearts underwent 30 minutes of reversible coronary artery occlusion, and were divided into six groups. Group 1 served as controls and underwent two hours of coronary reflow without global ischemic arrest. The remaining five groups were subjected to 45 minutes of cardioplegia-induced hypothermic arrest followed by two hours of normothermic reflow. Group 2 had a single infusion of crystalloid cardioplegia, and Group 3 received an oxygenated perfluorocarbon cardioplegic solution initially and again after 20 minutes of ischemia. After initial cardiac arrest with crystalloid cardioplegia, all hearts in Groups 4, 5, and 6 underwent a continuous infusion of a cardioplegic solution retrograde through the coronary sinus. Group 4 received a nonoxygenated crystalloid cardioplegic solution, Group 5 received an oxygenated crystalloid cardioplegic solution, and Group 6 received an oxygenated perfluorocarbon cardioplegic solution. With results expressed as the percent of infarcted myocardium within the region at risk, Group 2 hearts, which received only antegrade cardioplegia, had a mean infarct size of 44.8 +/- 6.3%, a 2.2-fold increase over controls (p less than 0.05). While antegrade delivery of oxygenated perfluorocarbon cardioplegia (Group 3) and coronary sinus perfusion with nonoxygenated crystalloid cardioplegia (Group 4) limited infarct size to 33.6 +/- 4.7% and 35.3 +/- 5.4%, respectively, only oxygenated cardioplegia delivered retrograde through the coronary sinus (Groups 5 and 6) completely prevented infarct extension during global ischemic arrest.(ABSTRACT TRUNCATED AT 250 WORDS)
为了确定通过冠状窦持续逆行灌注心脏停搏液是否能改善梗死心肌的挽救情况，54头猪被用于建立危险区域模型。所有心脏均经历30分钟可逆性冠状动脉闭塞，并分为六组。第1组作为对照组，经历两小时冠状动脉再灌注，无全心缺血性停搏。其余五组经历45分钟心脏停搏液诱导的低温停搏，随后两小时常温再灌注。第2组单次输注晶体心脏停搏液，第3组在缺血20分钟时最初接受一次全氟碳氧合心脏停搏液，20分钟后再次接受。在用晶体心脏停搏液进行初始心脏停搏后，第4、5和6组的所有心脏均通过冠状窦持续逆行输注心脏停搏液。第4组接受非氧合晶体心脏停搏液，第5组接受氧合晶体心脏停搏液，第6组接受氧合全氟碳心脏停搏液。结果以危险区域内梗死心肌的百分比表示，仅接受顺行心脏停搏液的第2组心脏平均梗死面积为44.8±6.3%，比对照组增加了2.2倍（p<0.05）。虽然顺行输注氧合全氟碳心脏停搏液（第3组）和用非氧合晶体心脏停搏液进行冠状窦灌注（第4组）将梗死面积分别限制在33.6±4.7%和35.3±5.4%，但只有通过冠状窦逆行输注氧合心脏停搏液（第5组和第6组）在全心缺血性停搏期间完全防止了梗死扩展。（摘要截短至250字）
