Morishita K, Inoue S, Baba T, Sakata J, Kazui T, Abe T
Department of Thoracic and Cardiovascular Surgery, School of Medicine, Sapporo, Japan.
Artif Organs. 1997 Jul;21(7):822-4. doi: 10.1111/j.1525-1594.1997.tb03750.x.
We have used heparin-bonded partial cardiopulmonary bypass to support distal aortic circulation during aortic cross-clamping. However, there were no cardiotomy reservoirs with fully reliable thromboresistance. To resolve this problem, a short-acting anticoagulant (nafamostat mesilate) was added into a cardiotomy reservoir. The present study was designed to evaluate the efficacy of our distal perfusion system. From May 1995 through the end of May 1996, 27 patients underwent descending thoracic and thoracoabdominal aortic aneurysm repairs with this adjunct, 4 being excluded from the experiment. Twenty patients who had undergone conventional partial cardiopulmonary bypass were defined as the control group. There were no significant differences between the 2 groups in the morbidity, mortality, gas transfer, or transfusion requirements despite the fact that more complicated surgical procedures (shown by a two-fold increase in the prevalence of reoperation) were required in the group that had received the current distal perfusion adjunct the heparin-bonded group. In conclusion, our perfusion system is very effective for descending thoracic and thoracoabdominal aortic aneurysm repairs.
我们在主动脉交叉钳夹期间使用肝素结合的部分体外循环来支持远端主动脉循环。然而，当时没有完全可靠的抗血栓形成能力的心脏切开储血器。为了解决这个问题，一种短效抗凝剂（甲磺酸萘莫司他）被添加到心脏切开储血器中。本研究旨在评估我们的远端灌注系统的疗效。从1995年5月到1996年5月底，27例患者使用此辅助装置进行了降胸段和胸腹主动脉瘤修复手术，4例被排除在实验之外。20例接受传统部分体外循环的患者被定义为对照组。尽管接受当前远端灌注辅助装置（肝素结合组）的患者需要更复杂的手术操作（再次手术发生率增加两倍），但两组在发病率、死亡率、气体交换或输血需求方面没有显著差异。总之，我们的灌注系统对于降胸段和胸腹主动脉瘤修复非常有效。
