Shanewise J S, Kosinski A S, Coto J A, Jones E L
Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, USA.
J Thorac Cardiovasc Surg. 1998 May;115(5):1166-71. doi: 10.1016/S0022-5223(98)70417-9.
Reoperative coronary artery bypass grafting presents unique challenges for myocardial preservation. The purpose of this study was to compare oxygenated blood cardioplegia with oxygenated crystalloid cardioplegia during reoperative coronary artery bypass grafting using transesophageal echocardiography to assess regional wall motion of the left ventricle before and after cardiopulmonary bypass.
Sixty-one patients undergoing reoperative coronary artery bypass grafting were prospectively randomized to receive oxygenated blood cardioplegia or oxygenated crystalloid cardioplegia delivered with a combined antegrade-retrograde technique. Transgastric short axis views of the left ventricle were made with transesophageal echocardiography during the operation before cardiopulmonary bypass and immediately after cardiopulmonary bypass. Regional wall motion was graded by a blinded observer, and before cardiopulmonary bypass scores were compared with after cardiopulmonary bypass scores.
No significant differences were found in the change in regional wall motion score from before cardiopulmonary bypass to after cardiopulmonary bypass between the blood and crystalloid cardioplegia groups.
This study found blood and crystalloid cardioplegia to be equally efficacious for myocardial preservation during reoperative coronary artery bypass grafting.
再次冠状动脉搭桥手术给心肌保护带来了独特的挑战。本研究的目的是在再次冠状动脉搭桥手术期间，使用经食管超声心动图评估体外循环前后左心室的区域壁运动，比较氧合血心脏停搏液与氧合晶体心脏停搏液的效果。
61例行再次冠状动脉搭桥手术的患者被前瞻性随机分组，分别接受采用顺行-逆行联合技术输注的氧合血心脏停搏液或氧合晶体心脏停搏液。在手术期间体外循环前及体外循环后立即用经食管超声心动图获取左心室的经胃短轴视图。由一名不知情的观察者对区域壁运动进行评分，并比较体外循环前与体外循环后的评分。
血心脏停搏液组和晶体心脏停搏液组在体外循环前至体外循环后区域壁运动评分的变化上未发现显著差异。
本研究发现，在再次冠状动脉搭桥手术期间，血心脏停搏液和晶体心脏停搏液在心肌保护方面同样有效。
