Kugelberg J, Hägerdal M, Carlsson C
Scand J Thorac Cardiovasc Surg. 1979;13(1):47-52. doi: 10.3109/14017437909101786.
Heart surgery with hypothermic cardioplegia during normothermic bypass is sometimes complicated by rewarming of the myocardium caused by collateral flow of arterial blood. This problem is particularly evident in surgery of congenital malformations. The present work is a comparative study in dogs on 3 methods of avoiding the rewarming problem. In the first group, the heart was kept cold and the warm blood was drained off from the left atrium. In the second group, total body hypothermia to the level desired was used and in the third group, normothermic cardioplegia was induced (Cardioplegin) in normothermic animals. In the two latter groups, the undesired temperature gradient between heart and body was eliminated. Evaluation of the differences was made by means of ventricular function determinations. Local, hypothermic cardioplegia showed the best postoperative function (69%) followed by the total body cooling which was fully acceptable (41%). Normothermic cardioplegia after the same duration of arrest showed a too low myocardial performance (20%).
在常温体外循环期间进行低温心脏停搏的心脏手术，有时会因动脉血的侧支循环导致心肌复温而变得复杂。这个问题在先天性畸形手术中尤为明显。本研究是在狗身上对三种避免复温问题的方法进行的比较研究。第一组，心脏保持低温，温暖的血液从左心房排出。第二组，将全身体温降至所需水平，第三组，在常温动物中诱导常温心脏停搏（心停搏液）。在后两组中，消除了心脏与身体之间不希望出现的温度梯度。通过心室功能测定来评估差异。局部低温心脏停搏术后功能最佳（69%），其次是全身降温，其效果完全可以接受（41%）。相同停搏时间后的常温心脏停搏显示心肌性能过低（20%）。
