[COMPARISON OF LEVELS OF MYOCARDIAL INJURY MARKERS AND THE STATE OF THE OXYGEN BUDGET IN PATIENTS WITH MITRAL...

The aim of our study was to compare the levels of myocardial damage markers and the state of the oxygen budget in patients with mitral valve insufficiency during its surgical correction, depending on the method of cardioprotection. We examined 85 patients with mitral valve insufficiency who underwent mitral valve replacement (MVR) surgery and anesthetic management according to the traditional method, the difference was only in the method of cardioprotection. In the I group (n=40) crystalloid cardioplegia (Bernsteinder's solution) was used, in the II group (n=45) - electrical fibrillation of the heart and intermittent clamping of the aorta. The level of markers of myocardial damage (MMD), indicators of the oxygen budget, and lactate were recorded in the patients. The method of cardioprotection of the heart did not affect the state of the myocardium, although such an indicator as the ratio of CPK MB/CPK was still lower in II group. In addition, in patients of this group, the state of the myocardium had a lesser effect on hemodynamic parameters. The oxygen budget was most influenced by the need for hemodilution, but indicators such as ΔSO2, ΔpO2, ΔCO2, EO2 and lactate levels indicate a more adequate supply of oxygen to tissues against the background of myocardial protection using electrical fibrillation of the heart and intermittent clamping of the aorta. Both methods of cardioprotection approximately equally affect the circulatory system, however, cardioprotection using electrical fibrillation of the heart and intermittent clamping of the aorta is more preferable.