Bull C, Cooper J, Stark J
J Thorac Cardiovasc Surg. 1984 Aug;88(2):287-93.
The advantages and limitations of cardioplegia as a mode of myocardial preservation in the pediatric cardiac surgical context are investigated. Review of early mortality related to ischemic time demonstrated no difference in overall mortality in consecutive series each of 200 patients, the first protected by reperfusion between intermittent periods of aortic cross-clamping and the second protected by cardioplegia. There was a tendency to accept longer ischemic time with cardioplegia (p less than 0.01). Mortality with cardioplegia increased sharply beyond 85 minutes of ischemia. Cytochemical and biophysical assessment of 129 pairs of right ventricular biopsy specimens taken before and after ischemia usually demonstrated deterioration of myocardium despite cardioplegia, and poor scores were predictive of hospital death. Use of a logistic analysis suggested that about half the hospital deaths were attributable to inadequate myocardial preservation despite cardioplegia.
研究了心脏停搏作为小儿心脏手术中心肌保护模式的优点和局限性。对与缺血时间相关的早期死亡率进行回顾发现，在每组200例患者的连续系列研究中，总体死亡率并无差异，第一组在主动脉交叉夹闭的间歇期通过再灌注进行保护，第二组通过心脏停搏进行保护。使用心脏停搏时有接受更长缺血时间的趋势（p小于0.01）。缺血超过85分钟后，心脏停搏导致的死亡率急剧上升。对129对缺血前后获取的右心室活检标本进行细胞化学和生物物理评估，通常显示尽管使用了心脏停搏，心肌仍出现恶化，评分较低预示着医院死亡。逻辑分析表明，尽管使用了心脏停搏，但约一半的医院死亡归因于心肌保护不足。
