Oster H, Schöllhorn J, Züchner K, Leitz K H
Thorac Cardiovasc Surg. 1983 Feb;31(1):31-4. doi: 10.1055/s-2007-1020288.
Delay in myocardial cooling during an infusion of cold cardioplegic solution may occur in patients with coronary artery disease. Forty patients with significant stenosis of the left anterior descending coronary artery (LAD) were divided into 3 groups according to the extent of the LAD stenosis. Group A consisted of 12 patients with 70% stenosis. Group B included 23 patients with 90% stenosis, and in group C there were 5 patients with LAD occlusion. Myocardial temperature was measured with a thermocamera during infusion of 2000 ml 8 to 10 degrees C cold Bretschneider's cardioplegic solution and compared to 10 other patients without coronary artery disease undergoing mitral valve replacement (group D). In group A the myocardium cooled to 15 degrees C after 4 1/2 minutes and to 12 degrees C after 10 minutes. In group B the myocardial temperature was 15 degrees C after 5 minutes and 12 degrees C after 10 minutes. In group C the temperature reached 18 degrees C after 5 minutes and 14 degrees C after 10 minutes. In group D the myocardial temperature was 12 degrees C after 3 minutes and 10 degrees C after 7 minutes. This study shows far better myocardial cooling rates in patients with unobstructed coronary arteries.
在输注冷心脏停搏液期间,冠心病患者可能会出现心肌降温延迟的情况。40例左前降支冠状动脉(LAD)严重狭窄的患者根据LAD狭窄程度分为3组。A组由12例狭窄70%的患者组成。B组包括23例狭窄90%的患者,C组有5例LAD闭塞患者。在输注2000毫升8至10摄氏度的冷布雷施奈德心脏停搏液期间,用热成像仪测量心肌温度,并与另外10例接受二尖瓣置换术的无冠状动脉疾病患者(D组)进行比较。A组心肌在4分半钟后冷却至15摄氏度,10分钟后冷却至12摄氏度。B组心肌温度在5分钟后为15摄氏度,10分钟后为12摄氏度。C组温度在5分钟后达到18摄氏度,10分钟后为14摄氏度。D组心肌温度在3分钟后为12摄氏度,7分钟后为10摄氏度。这项研究表明,冠状动脉通畅的患者心肌降温速度要快得多。