Salerno T A, Chiong M A
Ann Thorac Surg. 1983 Mar;35(3):280-7. doi: 10.1016/s0003-4975(10)61560-3.
The hemodynamic and metabolic effects of two consecutive 1-hour periods of cardioplegic arrest with a 20-minute interval of reperfusion or cardioplegic rearrest were evaluated in pig hearts. This model was designed to recreate in the laboratory a situation occasionally encountered during open-heart operation. Results indicate that at the end of 40 minutes of reperfusion following cardioplegic rearrest and 20 minutes after cardiopulmonary bypass (CPB), the stores of glycogen, adenosine triphosphate and total adenine nucleotides were lower than those found in hearts beating under CPB for an identical period of time. These stores were, however, sufficient to permit hemodynamic recovery, and they compared favorably with those found in hearts subjected to a single hour of cardioplegic arrest and reperfusion. The laboratory data and our previous clinical experience suggest that cardioplegic rearrest is a feasible alternative when surgical difficulties demand a second period of aortic cross-clamping after an initial period of cardioplegic arrest and reperfusion.
在猪心脏中评估了两个连续1小时的心脏停搏期（中间间隔20分钟的再灌注或心脏停搏后再停搏）的血流动力学和代谢效应。该模型旨在在实验室中重现心脏直视手术中偶尔遇到的情况。结果表明，在心脏停搏后再停搏40分钟的再灌注结束时以及体外循环（CPB）后20分钟，糖原、三磷酸腺苷和总腺嘌呤核苷酸的储备低于在相同时间段内在CPB下跳动的心脏中的储备。然而，这些储备足以实现血流动力学恢复，并且与经历1小时心脏停搏和再灌注的心脏中的储备相比具有优势。实验室数据和我们之前的临床经验表明，当手术困难需要在初始心脏停搏和再灌注期后进行第二次主动脉交叉钳夹时，心脏停搏后再停搏是一种可行的替代方法。
