[The intraoperative diagnosis of cardiomyocyte damage]

The morphology of myocardial biopsies taken in the course of the operative valve prosthesis is studied light and electron microscopically with the use of the fuchsinorrhagic index and tracer test. The dynamics and morphogenesis of cardiomyocyte injury depend upon their initial state. The myocardial changes characteristic of mitral valvular disease progress during the cardiac arrest. Besides that, observed the destabilization of membrane systems, tracer penetration of the injured cells and inner organelles, the fall of redox potential of mitochondria, the disturbance of the acidic hydrolases compartmentalization, the accumulation of multilamellar bodies indicating the membrane alteration. The combination of these changes determines the myocardial contractility in the period of rehabilitation and raises the risk during the prolonged operations. The suggested tests simultaneously give structural and metabolic estimation of the cardiomyocyte organelles in respect to the prognosis of irreversible injuries.