Comparison of cold blood and cold crystalloid cardioplegia on myocardial protection effects in valve replacement surgery / 中国医师杂志

Objective To compare the myocardial protection effects of cold blood cardioplegia and cold crystalloid cardioplegia in patients undergoing valve replacement surgery.Methods One hundred adult patients with cardiac function Ⅱ～Ⅲ class undergoing primary elective valve replacement surgery due to rheumatic heart disease were retrospectively analyzed.For patients with cardiac arrest,cold blood cardioplegia was applied to 50 cases(Group B),and cold crystalloid cardioplegia to the others(group C).The process of heart resuscitation,the postoperative need of dopamine,the blood pressure and heart rate,the postoperative level of serum myocardial enzyme,the intensive care unit(ICU) stay after operation were collected and statistically analyzed.All the cardioplegic solution was perfused in a similar manner and topical cooling was employed simultaneously.Results There were less cases in group B than in group C who needed isoprenaline for cardiac resuscitation after clamp removal(P0.05).Conclusion The cold blood cardioplegia and cold crystalloid cardioplegia have similar myocardial protection effects on rheumatic heart disease patients with cardiac function Ⅱ～Ⅲ class undergoing valve replacement surgery.

The effect of initial lower PO_2 controlled reperfusion on cyanotic hypoxic immature myocardial protection / 中华胸心血管外科杂志

Objective: To explore the effect of initial lower PO_2 controlled reperfusion on cyanotic hypoxic immature myocardium protective during post-ischemia reperfusion. Methods: 24 hypoxic neonatal rabbits were randomized into 3 groups (8 in each group). Group I (initial lower PO_2 controlled reperfusion), group II (normal PO_2 controlled reperfusion), group III (high PO_2 reperfusion group). Using isolate heart Langendorff ischemia-reperfusion model, the myocardial protection results were observed and the mechanism were discussed from molecular biological and ultrastructural view. Results: Compared with high PO_2 reperfusion group and normal PO_2 reperfusion group, the products of oxygen free radical were lowered at the end of reperfusion in initial lower PO_2 controlled reperfusion group. ATP content was increased, myocardial contractility was elevated, coronary sinus flow was raised, the degree of myocardium edema was reduced, and ultrastructure alteration was lessened significantly. Conclusion: Initial lower PO_2 controlled reperfusion reduces oxygen free radical injury, enhances myocardial energy metabolism, lessens myocytic structure destruction and improves postischemic function recovery of cyanotic myocardium.