ABSTRACT
Ultrastructure of air-hematic barrier and efficiency of alpha-tocopherolum use for prophylaxis of toxic effect of oxygen used for artificial pulmonary ventilation (APV) and oxygenation of blood outside lungs were studied in 27 patients with mitral and aortal valve diseases and ischemic disease before the operation and on its stages. Macroscopically unchanged lung regions were studied before the heart-lung apparatus switching, 40-45 minutes after clamping the artery in conditions of disturbed blood circulation and 10 minutes after hemostation in pulmonary artery. 6 patients were treated with 100% oxygen for 30 minutes before APV finishing while the other 6 previously received alpha-tocopherolum. Disturbance of the structure of the outermost cell membrane in type I alveolocytes and endotheliocytes, widening of basal layers and their fibers and disorders in the osmiophilic lamellar bodies were established to determine the severity of condition of patients with mitral valve diseases.
Subject(s)
Aortic Valve/ultrastructure , Blood-Air Barrier , Mitral Valve , Myocardial Ischemia/pathology , Pulmonary Alveoli/ultrastructure , Antioxidants/therapeutic use , Aortic Valve/drug effects , Blood-Air Barrier/drug effects , Chronic Disease , Combined Modality Therapy , Epithelium/drug effects , Epithelium/ultrastructure , Heart Valve Diseases/drug therapy , Heart Valve Diseases/pathology , Heart Valve Diseases/surgery , Humans , Mitral Valve/drug effects , Mitral Valve/ultrastructure , Myocardial Ischemia/drug therapy , Myocardial Ischemia/surgery , Postoperative Complications/pathology , Premedication , Pulmonary Alveoli/drug effects , Respiratory Insufficiency/pathology , Time Factors , Vitamin E/therapeutic useABSTRACT
A comparative investigation of ultrastructural changes in the lungs of 28 cardiosurgical patients operated upon under conditions of bubble and membrane oxygenation of blood has established that the following trends are perspective for lessening the disturbances of the lung ultrastructure in operations on the open heart: shorter time of the first parallel blood flow when using bubble oxygenation, less trauma of the heart during artificial blood circulation due to the improved perfusion system, realization of the conditions of extrapulmonary oxygenation of blood, responsible for the prevention of hypoxic injuries of the lungs.
Subject(s)
Coronary Artery Bypass , Heart Valve Prosthesis , Lung/ultrastructure , Oxygenators, Membrane , Oxygenators , Aortic Valve , Biopsy , Extracorporeal Circulation , Female , Humans , Intraoperative Period , Male , Microscopy, Electron , Mitral ValveABSTRACT
Gas-exchange properties of membrane oxygenators (MO) "MOST-122" with immobilized heparin have been studied during 18 open heart surgeries. It has been shown that heparin immobilization on MO surfaces that are in contact with blood is accompanied by enhanced MO ability to oxygenate blood and remove CO2.
Subject(s)
Heparin , Oxygenators, Membrane , Pulmonary Gas Exchange , Aortic Valve , Carbon Dioxide/blood , Extracorporeal Circulation , Heart Valve Prosthesis , Humans , Mitral Valve , Oxygen/blood , Partial Pressure , Surface PropertiesABSTRACT
The analysis of 20 operations on the open heart performed with selective cytopheresis (apparatus PK-0.5) or without it has demonstrated that in pharmacological and ice-chip cardioplegia the technique to a great extent prevents the loss of the patient's own blood removed with cardioplegic solution and makes it possible to reduce donor blood consumption by 27%. The course of the postoperative period improves considerably: blood loss is reduced, the recovery of blood cellular composition becomes more intensive. Cardioplegia performed in combination with selective cytopheresis does not exclude certain protein loss (up to 15 g/l during one session), which confirms the necessity of adequate homeostasis correction with protein blood preparations.
Subject(s)
Blood Transfusion, Autologous , Cardiac Surgical Procedures , Heart Arrest, Induced , Plasmapheresis , Adolescent , Adult , Humans , MaleABSTRACT
The analysis of 65 cases of cardiopulmonary bypass surgery using systems distinct in the type of the oxygenator used (contact, membrane) and the degree of thromboresistance of blood-contacting surfaces has demonstrated that the use of heparin-covered membrane blood oxygenators and systems allows of a considerable reduction in blood trauma during perfusion and a 5-6-fold decrease of heparin doses employed for extracorporeal membrane blood oxygenation.
