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[Cardioplegia according to Bretschneider for valve replacement: clinical experiences and electronmicroscopical
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.
Abstract:
We report about clinical experiences with the cardioplegia according to Bretschneider combined with deep selective hypothermia of the heart in 44 patients. Before, during and after cardioplegia we made biopsies from the left ventricle of 6 patients for electronmicroscopical examinations. Besides the mitochondrial changes already known we saw a break-down of the nexuses. We discuss the importance if these changes for the action of the cardioplegia. Both changes seemed to be reversible. The clinical results and the immediate and later postoperative follow-up demonstrate, that with the described technique a good myocardial protection can be done. This procedure allows operating with a low risk at a completely arrested and relaxed heart until 130 minutes.