Kalmar P, Manske J, Tilsner V, Akrami R
Thoraxchir Vask Chir. 1978 Aug;26(4):306-10. doi: 10.1055/s-0028-1096644.
The degree of intraoperative myocardial injury was determined in two groups undergoing different methods of myocardial protection by observing the LDH and its isoenzymes up to the 11th postoperative day. Both groups consisted of patients who underwent mitral- and aortic-valve replacement. In the first group myocardial protection consisted of Kirsch cardioplegia (2) combined with conventional coronary perfusion in cases of aortic-valve replacement. In the second group the same initial cardioplegic procedure was followed by the noncorpuscular, hypothermic and aerobic coronary perfusion by Bleese and Döring (1). No difference was noted among the mitral valve patients. During the 11 days postoperative period, the aortic valve patients in the first group demonstrated a significantly higher LDH activity than the mitral-valve cases whereas LDH activity of aortic-valve patients in the second group resembled that of the mitral valve cases. Since the length of extracorporal circulation and ischemia did not vary significantly, the LDH behavior in the aortic-valve cases of the first group may be explained by the inferiority of the myocardial protection method used. In comparison with the other methods conventional coronary perfusion resulted in more myocardial injury.
通过观察术后第11天的乳酸脱氢酶（LDH）及其同工酶，确定了接受不同心肌保护方法的两组患者术中心肌损伤的程度。两组均由接受二尖瓣和主动脉瓣置换术的患者组成。第一组的心肌保护包括在主动脉瓣置换术时采用Kirsch心脏停搏液（2）并结合传统冠状动脉灌注。第二组在相同的初始心脏停搏程序后，采用Bleese和Döring的非细胞、低温、有氧冠状动脉灌注（1）。二尖瓣患者之间未发现差异。在术后11天内，第一组主动脉瓣患者的LDH活性明显高于二尖瓣患者，而第二组主动脉瓣患者的LDH活性与二尖瓣患者相似。由于体外循环时间和缺血时间没有显著差异，第一组主动脉瓣病例中LDH的表现可能是由于所用心肌保护方法较差所致。与其他方法相比，传统冠状动脉灌注导致更多的心肌损伤。
