Krymskiĭ L D, Saprygin D B, Bogonatov B N, Migalina L A
Arkh Patol. 1986;48(6):3-8.
During surgical correction of Fallot's tetrad the authors discovered the decrease of macroergic phosphate concentration and moderately marked signs of cardiomyocytic ultrastructural changes, such as mitochondrial injuries, decrease of glycogen levels, insignificant intracellular edema, no increase of membrane penetration. Changes of endothelial cells were absent. In children not over 1 year old under myocardial protection with hypothermic perfusion (at low volume rates) some decrease of macroergic phosphates occurred, as well as a moderate decrease of the mitochondrial index, glycogen content decrease, there was no intracellular edema. The discovered structural changes are minimal and reversible. A close correlation was found between the electron microscopic data and the character of myocardial energetic metabolism, the biochemical changes preceding the ultrastructural ones. Comparison of morpho- and biochemical changes in the myocardium of the majority of patients with impaired myocardial function confirmed the existence of a complex relationship between them.
在法洛四联症的外科矫正过程中，作者发现高能磷酸酯浓度降低，以及心肌细胞超微结构改变的中度明显迹象，如线粒体损伤、糖原水平降低、细胞内轻度水肿、膜通透性未增加。内皮细胞无变化。在1岁以下儿童中，采用低温灌注（低流量）进行心肌保护时，高能磷酸酯出现一定程度降低，线粒体指数也有中度下降，糖原含量减少，无细胞内水肿。所发现的结构变化微小且可逆。电子显微镜数据与心肌能量代谢特征之间存在密切相关性，超微结构变化之前存在生化变化。对大多数心肌功能受损患者心肌的形态学和生化变化进行比较，证实了它们之间存在复杂关系。
