逆行热连续心脏对右心室功能的影响
M LeBoutillier1, E A Grossi, B M Steinberg
1Department of Surgery, New York University Medical Center, NY 10016.
Circulation
|November 1, 1994
概括
逆行热连续心脏 (RWCC) 可能会影响心脏手术后右心室功能恢复. 与逆行性冷多剂量心肌相比,这种方法显示RV功能明显减弱,因此需要谨慎使用.
科学领域:
- 心血管外科心血管外科
- 肌心脏的保护 肌心脏的保护
- 室腔功能 室腔功能
背景情况:
- 逆行热连续心脏 (RWCC) 是一种拟议的心肌保护技术.
- 关于RWCC对右心室 (RV) 功能影响的数据有限.
- 之前的研究表明心肌的分布不佳,以RV和心室间隔膜与逆行方法.
研究的目的:
- 为了评估逆行热连心 (RWCC) 后右心室的功能性保存.
- 为了比较RWCC和逆行性冷多剂量心脏 (RCMC) 之间的RV功能恢复.
主要方法:
- 蒙格勒犬 (n=14) 经过90分钟的主动脉交叉紧,其中RWCC (n=7) 或RCMC (n=7) 在前级停止后.
- 使用声微仪和压力传感器测量左和右心室 (LV, RV) 压力-体积关系.
- 室内功能被评估在停止之前,在解锁后的30分钟和60分钟.
主要成果:
- 与RCMC (79.40% +/- 13.82%) 相比,RWCC导致在再输血30分钟后RV功能恢复显著减弱 (41.03% +/- 7.49%).
- 在再输血后60分钟,RWCC (48.05% +/- 9.72%) 与RCMC (61.95% +/- 8.70%) 的VR功能仍然较低.
- 在任何时间点,在RWCC和RCMC之间没有观察到LV功能恢复的显著差异.
结论:
- 逆行热连续心脏 (RWCC) 显示了RV功能障碍的潜力.
- 与RWCC相比,RCMC似乎提供了优越的RV功能恢复.
- 建议在使用RWCC时谨慎使用,特别是在先前存在RV缩的患者中.
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