Robicsek F, Masters T N, Svenson R H, Daniel W G, Daugherty H K, Cook J W, Selle J G
Surgery. 1978 Dec;84(6):858-64.
The technique presented in this paper is based on the authors' previous observations in which they found that artificial decrease of blood flow to a portion of the heart muscle leads to an immediate and proportional drop in the regional myocardial temperature. It appeared to the authors as a logical next step to apply the thermographic camera to a monitor and to record such changes in the human patient during coronary surgery and to use the data to draw conclusions applicable to regional blood supply and to blood flow through surgically inserted vein grafts. They found that, on the normothermic heart, there were well-identifiable "cold" patches corresponding with areas of impaired coronary circulation. By infusion of blood to the ischemic myocardium through individual release of the bypass grafts, the thermogram responded by immediate appearance of "warm" spots corresponding with the areas supplied by the grafts. Even more dramatic demonstration of graft patency and outline of the area supplied by the graft could be performed by injecting cold saline solution into the grafted saphenous veins. In the author's experience this most interesting new method proved to be a useful tool in coronary surgery both as an adjunct in delineating ischemic areas and in proving the patency and efficiency of the grafts inserted.
本文介绍的技术基于作者先前的观察结果,他们发现人为减少部分心肌的血流量会导致局部心肌温度立即成比例下降。作者认为,接下来合乎逻辑的一步是将热成像仪应用于监视器,在冠状动脉手术期间记录人类患者的此类变化,并利用这些数据得出适用于局部血液供应和通过手术插入的静脉移植物的血流情况的结论。他们发现,在常温心脏上,存在与冠状动脉循环受损区域相对应的可清晰识别的“冷”斑。通过逐个松开旁路移植物向缺血心肌供血,热成像图会立即出现与移植物供血区域相对应的“热”点。通过向移植的大隐静脉注射冷盐水溶液,甚至可以更显著地证明移植物的通畅情况以及移植物供血区域的轮廓。根据作者的经验,这种非常有趣的新方法被证明是冠状动脉手术中的一种有用工具,既可以作为描绘缺血区域的辅助手段,也可以用于证明插入的移植物的通畅性和有效性。