Continuous normothermic blood cardioplegia: Initial experience
Tóm tắt
The concept of continuous normothermic blood cardioplegia has been developed on the principles of electromechanical arrest and normothermic aerobic perfusion. This method appears to be a safer alternative to current methods of hypothermic myocardial protection. We report our experience with the use of continuous normothermic blood cardioplegia in twenty patients who underwent cardiac surgery. The analysis of results included cardiopulmonary bypass events, potassium kinetics, recovery rhythm, need for cardioversion and inotropes, and reperfusion time. From the initial results, it appears that the technique of normothermic cardioplegia is reproducible and safe. Its advantage lies in the shorter reperfusion periods and it has a potential to become the first choice method of myocardial protection in procedures involving long cross-clamp periods.
Tài liệu tham khảo
Lichtenstein SV, Ashe KA, El Dalati H, Cusimano RJ, Panos A, Slutsky AS. Warm heart surgery,J Thorac Cardiovasc Surg 1991;101: 269–74.
Lictenstein SV, Fremes SE, Abel JG, Christakis GT, Salerno TA. Technical aspects of warm heart surgery.J Card Surg 1991;6: 278–84.
Lichtenstein SV, Abel JG, Panos A, Slutsky AS, Salerno TA. Warm heart surgery: experience with long cross clamp times.Ann Thor Surg 1991;52: 1009–13.
Lichtenstein SV, El-Dalati H, Panos A, Slutsky AS. Long cross-clamp times with warm heart surgery.Lancet 1989;1: 1443.
Melrose DG, Dieger DB, Bentall HH, Baker JBE, Elective Cardiac arrest. Preliminary communications.Lancet 1955;2: 21–2.
Bigelow WG, Lindsay WK, Greenwood WF. Hypothermia: its possible role in cardiac surgery.Ann Surg 1950;132: 849–66.
Bernhard WF, Schwarz HF, Malick NP. Studies of the effects of hypothermic cardiac arrest in normothermic animals.Ann Surg 1961;153: 43–51.
Buckberg GD, Brazier JR, Nelson RI,et al. Studies of the effects of hypothermia on regional myocardial blood flow and metabolism during cardiac pulmonary bypass.J Thorac Cardiovasc Surg 1977;73: 87–94.
Buckberg GD, Myocardial temperature during aortic clamping for cardiac surgery. Protection, preoccupation and perspective.J Thorac Cardiovasc Surg 1991;102: 895.
Fuhrman GJ, Fuhrman FA. Utilization of glucose by the hypothermic rat.An J Physiol 1963;295: 181–3.
Kaigser L, Janson E, Schmidt W, Bonfin V. Myocardial energy depletion during profound hypothermic cardioplegia for cardiac operations.J Thorac Cardiovasc Surg 1985;90: 895–900.
Bigelow WG, Lindsay WK, Harrison RC, Gordon RA, Greenwood WF. Oxygen transport and utilization in dogs at low body temperature.Ann J Physiol 1950;160: 125–30.
Rahn H, Reenes, RB, Howell BJ. Hydrogen ion regulation, temperature and evolution.Am Rev Respir Dis 1975;112: 165–72.
Tutassaura H, Continuous warm blood cardioplegia (letter).Ann Thor Surg 1991;51 866–7.