[Emergency craniocerebral hypothermia in the management of open mitral commissurotomy]
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Craniocerebral hypothermia safely reduced brain temperature and oxygen consumption during open-heart surgery for mitral stenosis. This technique proved effective, even with extended vessel occlusion, resulting in low mortality rates.
Area of Science:
- Cardiovascular Surgery
- Neurology
- Hypothermia Research
Context:
- Mitral stenosis poses significant risks during open-heart surgery.
- Intraoperative findings during closed mitral commissurotomy guided surgical decisions.
- Established surgical protocols for complex cardiac cases.
Purpose:
- To evaluate the safety and efficacy of craniocerebral hypothermia in open-heart surgery for mitral stenosis.
- To investigate the pathophysiological effects of craniocerebral hypothermia on brain temperature and oxygen consumption.
- To assess the impact of prolonged major vessel occlusion under hypothermia on patient outcomes.
Summary:
- Craniocerebral hypothermia was applied to 69 patients undergoing open-heart surgery for mitral stenosis.
- The study observed a decrease in brain temperature and total oxygen consumption (up to 27.7%).
- Prolonged major vessel occlusion (up to 25 min) did not negatively affect patient condition, complications, or lethality (2.9% hospital mortality).
Impact:
- Craniocerebral hypothermia demonstrates safety and effectiveness for emergency open-heart procedures.
- The findings support the use of hypothermia to mitigate risks associated with complex cardiac surgeries.
- This technique offers a viable option for managing patients with severe mitral stenosis requiring surgical intervention.
Abstract:
Craniocerebral hypothermia was used during open-heart surgery in 69 patients with mitral stenosis (hospital mortality rate 2.9%). Indications for open-heart surgery (left atrial thrombosis, mitral valve calcinosis, onset of traumatic mitral insufficiency) were determined intraoperatively during closed mitral commissurotomy. Some pathophysiological peculiarities of craniocerebral hypothermia were studied. A decrease in brain temperature and total oxygen consumption (up to 27.7% of the basic metabolism level) has been observed. Prolongation (up to 25 min) of major vessel occlusion had no negative effect on the patients' condition, postoperative complications and lethality. Craniocerebral hypothermia is considered to be a safe and effective technique indicated in case of emergency for open-heart surgery.