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[Cardioplegia according to Bretschneider for valve replacement: clinical experiences and electronmicroscopical

I Volkmer, G Dahl, K Raman

    Thoraxchirurgie, Vaskulare Chirurgie
    |December 1, 1977
    PubMed

    Insights

    Bretschneider cardioplegia with deep selective hypothermia offers effective myocardial protection. This cardiac surgery technique allows safe, extended operating times on a still, relaxed heart, with observed reversible cellular changes.

    Area of Science:

    • Cardiology
    • Cardiac Surgery
    • Cell Biology

    Context:

    • Clinical application of Bretschneider cardioplegia combined with deep selective hypothermia.
    • Evaluation of myocardial protection strategies in cardiac surgery.
    • Investigation of cellular changes during cardiac arrest.

    Purpose:

    • To assess the clinical efficacy of Bretschneider cardioplegia and deep selective hypothermia.
    • To examine ultrastructural changes in myocardial tissue post-cardioplegia.
    • To correlate cellular findings with clinical outcomes and myocardial protection.

    Summary:

    • The study reports clinical experiences with Bretschneider cardioplegia and deep selective hypothermia in 44 patients.
    • Electron microscopy of left ventricle biopsies revealed mitochondrial changes and nexus breakdown, both appearing reversible.
    • Clinical results and follow-up indicate good myocardial protection, enabling up to 130 minutes of operating time on a arrested, relaxed heart.

    Impact:

    • Demonstrates a safe and effective method for myocardial protection during complex cardiac surgeries.
    • Provides insights into the reversible cellular mechanisms underlying cardioplegia's protective effects.
    • Supports the use of this technique for extended cardiac procedures with reduced surgical risk.

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