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SM ISO690:2012 GUZGAN, Iurie, MANOLACHE, Gheorghe, REPIN, Oleg, BATRÎNAC, Aureliu, MOSCALU, Vitalie, CORCEA, Vasile. Protection of hypertrophied myocardium in cardiac surgery. In: Cercetarea în biomedicină și sănătate: calitate, excelență și performanță, Ed. 1, 20-22 octombrie 2021, Chişinău. Chișinău, Republica Moldova: 2021, p. 424. ISBN 978-9975-82-223-7 (PDF).. |
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Cercetarea în biomedicină și sănătate: calitate, excelență și performanță 2021 | |||||||
Conferința "Cercetarea în biomedicină și sănătate: calitate, excelență și performanță" 1, Chişinău, Moldova, 20-22 octombrie 2021 | |||||||
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Pag. 424-424 | |||||||
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Background. Myocardial hypertrophy leads to difficulties in adequate protection from ischemia during cardiac surgery. Blood cardioplegia (CPL) shows to be an alternative, low cost method for this purpose Objective of the study. To determine the efficiency of hypertrophied myocardium (HM) protection by isothermal blood cardioplegia, under mild to moderate hypothermia in aortic valvular surgery. Material and Methods. 86 patients operated for prosthetic aortic valve repair, mitral valve plasty with or without tricuspid valve plasty. Aortal cross-clamp - 100-170 min. 41 patients - LV diastolic volume >150ml/sq.m. (Gr.1); 45 - <150ml/sq.m. (Gr.2). Selective blood CPL To 30°C - 33°C, supplemented with Mg++, was applied every 20-25 min. Patients’ data - with no differences between groups. Results. After aortic clamp release Gr.1 demonstrated a capacity to restore rhythm similar to that of gr.2. Out of 41 patients, the heart in Gr.1 restarted spontaneously in 29 (70.7%). Cardioversion required 12 patients (29.2%), total number of defibrillation being 15. In Gr.2 of 45 patients 13 (28.8%) required 16 defibrillations. AV block was expressed identical in both groups. The need in catecholamine was the same. In Gr.1 8 patients (19.5%) required high doses inotropic support and in group II - 9 patients (20.0%). Duration of stay in the ICU was 2,8±0,9 days for the Gr.1, versus 2,6±0,8, Gr.2. No deaths. Conclusion. Isothermal intermittent blood CPL under To 30-33°C constantly supplemented with Mg ++ provides good protection of HM over a standard period (20-25 minutes) of ischemia between reperfusions and has a positive effect on contractility in the immediate postoperative period. |
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Cuvinte-cheie myocardium, hypertrophy, cardiac surgery, protection, miocard, hipertrofie, chirurgie cardiacă, protecţie |
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