Tolis G A, Astras G, Sfyras N, Georgiou G
Department of Cardiothoracic Surgery, Diagnostic and Therapeutic Center of Athens HYGEIA, S.A., Greece.
Cardiovasc Surg. 1995 Apr;3(2):175-80. doi: 10.1016/0967-2109(95)90890-h.
From 1 March 1992 too 31 July 1993 (17 months), 480 consecutive patients underwent various open-heart procedures under anterograde (83 patients) or retrograde (397 patients) or retrograde (397 patients) continuous warm blood cardioplegia. Some 352 patients (73.3%) had isolated coronary artery bypass grafts (CABG) and 117 (24.3%) had valve replacement either isolated (96) or in combination with other operations (21). Two patients had CABG and ventricular aneurysmectomy, eight had correction of congenital defects, and one had resection of left atrial myxoma. The 30-day postoperative mortality rate was 2.9% (14 deaths). In four patients the cause of death was not cardiogenic. An intra-aortic balloon was used in 11 patients following CABG (3.1%) with six survivors. Perforation of the coronary sinus occurred in one patient. Perioperative myocardial infarction was observed in 5.6% of patients after CABG. No myocardial infarction occurred after valve replacement. Phrenic nerve injury and wound infection were not observed. These results indicate that warm blood cardioplegia, especially when delivered retrogradely, provides excellent myocardial protection of both ventricles during various open-heart procedures.
从1992年3月1日至1993年7月31日（17个月），480例连续患者在顺行（83例）或逆行（397例）持续温血心脏停搏下接受了各种心脏直视手术。约352例患者（73.3%）接受了单纯冠状动脉旁路移植术（CABG），117例（24.3%）接受了瓣膜置换术，其中单纯瓣膜置换术96例，瓣膜置换术联合其他手术21例。2例患者接受了CABG和心室壁瘤切除术，8例患者接受了先天性缺陷矫正，1例患者接受了左心房黏液瘤切除术。术后30天死亡率为2.9%（14例死亡）。4例患者的死亡原因并非心源性。11例CABG术后患者（3.1%）使用了主动脉内球囊，其中6例存活。1例患者发生冠状窦穿孔。CABG术后5.6%的患者观察到围手术期心肌梗死。瓣膜置换术后未发生心肌梗死。未观察到膈神经损伤和伤口感染。这些结果表明，温血心脏停搏，尤其是逆行灌注时，在各种心脏直视手术中能为双心室提供极佳的心肌保护。
