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体外循环期间进行局部心脏低温能否保护心肌免受长期的形态和功能损伤?

Does local cardiac hypothermia during cardiopulmonary bypass protect the myocardium from long-term morphological and functional injury?

作者信息

Schraut W, Lamberti J J, Kampman K, Anagnostopoulos C, Replogle R, Glagov S

出版信息

Ann Thorac Surg. 1977 Oct;24(4):315-22. doi: 10.1016/s0003-4975(10)63406-6.

Abstract

Twenty-eight dogs were subjected to 90 minutes of hypothermic (30 degrees C) cardiopulmonary bypass with moderate hemodilution. In 6 dogs the heart was vented and beating for 60 minutes. Eight dogs underwent ventricular fibrillation with coronary perfusion (VF + CP). In 14 dogs the aorta was cross-clamped for 60 minutes while the myocardium was protected by local cardiac hypothermia (ICA + LCH). Eighteen animals survived. Hemodynamic studies at seven weeks revealed no major differences among the three groups. At postmortem examination, no gross scarring was noted in any heart. Microscopical examination of 14 hearts was completely-normal. In the VF + CP group, 2 hearts had isolated microscopical scars. Similar linear subendocardial scars (less than or equal to 1.5 X 0.5 mm) were noted in 2 hearts subjected to ICA + LCH. Survival after 60 minutes of VF + CP or ICA + LCH did not result in long-term morphological injury to or functional impairment of the myocardium.

摘要

28只狗接受了90分钟的低温(30摄氏度)体外循环,并伴有中度血液稀释。6只狗心脏排气并跳动60分钟。8只狗进行了冠状动脉灌注的心室颤动(VF + CP)。14只狗主动脉交叉阻断60分钟,同时心肌通过局部心脏低温保护(ICA + LCH)。18只动物存活。七周时的血流动力学研究显示三组之间无重大差异。尸检时,任何心脏均未发现明显瘢痕。14颗心脏的显微镜检查完全正常。在VF + CP组中,2颗心脏有孤立的显微镜下瘢痕。在接受ICA + LCH的2颗心脏中也发现了类似的线性心内膜下瘢痕(小于或等于1.5×0.5毫米)。60分钟的VF + CP或ICA + LCH后的存活并未导致心肌的长期形态学损伤或功能损害。

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