[Evaluation of the efficacy of human heart protection during cardioplegia].
Materials from 546 intraoperative incision biopsies from 253 patients were studied in order to assess the effectiveness of myocardium protection during operations on the open heart. No significant ultrastructural, metabolic or functional changes develop in the myocardium upon pinching of the aorta and ischemia for 10 min, therefore myocardium protection is unnecessary. In ischemia for up to 40 min ultrastructural changes in cardiomyocytes are reversible therefore deep hypothermia proved to be sufficient for myocardium protection. When the aorta is pinched for up to 60 min under conditions of cold cardioplegia, ultrastructural changes in cardiomyocytes may be reversible but they depend upon the initial condition of the heart muscle and precise accomplishment of all the requirements of this type of myocardial protection. Cryopharmacological cardioplegia allows one to shut down the heart from the circulation safely for 120 min which has been confirmed by the results of electron microscopic and histochemical studies and the results of clinical examinations of the patients. Incisional intraoperative biopsy allows the judgement of the effectiveness of myocardium protection during asystole due to the pinched aorta, of the initial changes of the myocardium, i. e. the preoperative background, of the subtle features of metabolism and function of the myocardial cell to be made. The open incisional intraoperative biopsy of the myocardium is more informative than the puncture endomyocardial one.
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003326:Coronary Circulation; D006324:Heart Arrest, Induced; D006349:Heart Valve Diseases / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007432:Intraoperative Period; D007511:Ischemia / Q000517:prevention & control*; D008854:Microscopy, Electron; D009206:Myocardium / Q000648:ultrastructure*
Otsenka éffektivnosti zashchity miokarda cheloveka pri kardioplegii.