Nagata M, Tashiro T, Nakamura M, Tanaka K, Haruta Y, Todo K
Department of Thoracic and Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan.
Kyobu Geka. 1993 Sep;46(10):836-40.
We applied the Continuous Warm Blood Cardioplegia (CWBC) as an approach to improve myocardial preservation. From March to June in 1992, we used the CWBC in six patients and the conventional cold crystalloid cardioplegia (CCCP) in seven patients. All of them underwent isolated coronary artery bypass grafting. There was no marked difference between the CWBC and CCCP in post operative serum level of creatine kinase (MB type), cardiac output and dose of dopamine during they weaned from cardiopulmonary bypass. All patients treated with CWBC spontaneously restored the normal sinus rhythm shortly after removal of the aortic crossclamp, which was distinct from the fact that the CCCP group showed no such recovery. This result suggest that CWBC kept high-energy phosphate level without disturbing production of ATP in myocardium. Furthermore, reperfusion injury was also likely to be prevented by CWBC.
我们应用持续温血心脏停搏液(CWBC)作为一种改善心肌保护的方法。1992年3月至6月,我们对6例患者使用了CWBC,对7例患者使用了传统的冷晶体心脏停搏液(CCCP)。所有患者均接受了单纯冠状动脉搭桥术。在术后肌酸激酶(MB型)血清水平、心输出量以及脱离体外循环期间多巴胺用量方面,CWBC和CCCP之间没有显著差异。所有接受CWBC治疗的患者在解除主动脉阻断钳后不久均自发恢复正常窦性心律,这与CCCP组未出现这种恢复的情况不同。这一结果表明,CWBC可维持心肌高能磷酸水平,同时不干扰心肌中ATP的产生。此外,CWBC也可能预防了再灌注损伤。