Singh H M, Horton E H
Thorax. 1971 Jan;26(1):89-93. doi: 10.1136/thx.26.1.89.
Forty patients who came to necropsy over a period of five years due to myocardial damage sustained during cardiac valve replacements were studied. The clinical presentation of myocardial damage was assessed in relation to the preoperative cardiac status. The cause and nature of myocardial damage were assessed at necropsy. Evidence of clinical, electrocardiographic and aortographic coronary atheroma was correlated with distribution at necropsy, and the value of selective coronary angiography in perfusing the coronary arteries during cardiopulmonary bypass is stressed. The causes of myocardial damage could be classified as () thrombo-embolic, () iatrogenic damage to the coronary arteries, and () poor or absent coronary perfusion during cardiopulmonary bypass. A case is made for the importance of coronary perfusion during cardiopulmonary bypass.
对40例在心脏瓣膜置换术中因心肌损伤而在5年期间接受尸检的患者进行了研究。根据术前心脏状况评估心肌损伤的临床表现。在尸检时评估心肌损伤的原因和性质。将临床、心电图和主动脉造影冠状动脉粥样硬化的证据与尸检时的分布情况进行关联，并强调了选择性冠状动脉造影在体外循环期间灌注冠状动脉的价值。心肌损伤的原因可分为：（）血栓栓塞，（）冠状动脉医源性损伤，以及（）体外循环期间冠状动脉灌注不良或无灌注。文中阐述了体外循环期间冠状动脉灌注的重要性。
