Schaper J, Schwarz F, Kittstein H, Stämmler G, Winkler B, Scheld H, Hehrlein F
Ann Thorac Surg. 1982 Feb;33(2):116-22. doi: 10.1016/s0003-4975(10)61895-4.
During open-heart operation, myocardial biopsies were taken from 31 patients undergoing aortic valve replacement during total cardiopulmonary bypass. The first needle biopsy was taken before induction of cardiac arrest (Kirsch cardioplegia), the second at the end of global ischemia, and the third during the reperfusion period. Teh tissue was investigated by electron microscopy, in both a qualitative and a quantitative manner (morphometry). Ultrastructural morphometry revealed cellular and especially mitochondrial swelling that occurred during the reperfusion phase, but not after ischemia alone. On the basis of morphological measurements, this study shows the occurrence of postischemic cellular and mitochondrial edema that possibly might be avoided by the use of improved techniques of myocardial protection during operation.
在心脏直视手术期间，从31例在全心肺转流期间接受主动脉瓣置换术的患者身上获取心肌活检样本。第一针活检在心脏停搏诱导前（Kirsch心脏停搏液）采集，第二针在全心缺血结束时采集，第三针在再灌注期采集。对组织进行了电子显微镜检查，包括定性和定量（形态计量学）研究。超微结构形态计量学显示，细胞肿胀尤其是线粒体肿胀发生在再灌注期，而单独缺血后未出现。基于形态学测量，本研究表明缺血后细胞和线粒体水肿的发生，通过术中采用改进的心肌保护技术可能避免这种情况。
