[Myocardial protection during aortic valve replacement: effectiveness of continuous warm blood cardioplegia].
Effectiveness of continuous warm blood cardioplegia (CWBC) during aortic valve replacement (AVR) was studied by comparing with intermittent cold GIK cardioplegia (ICGC) in 32 patients who underwent AVR using CWBC in 16 and ICGC in the other 16 patients. There was no operative nor hospital death in this series. In CWBC group, spontaneous recovery of the heart beat following aortic declamping was seen in 14 of 16 patients (87.5%), in contrast only in 4 of 16 (25%) in ICGC group. During the early postoperative period, left ventricular stroke work index (g.m/beat/m2) significantly increased from 41.0 +/- 14.4 to 55.9 +/- 8.0 (p < 0.001) in CWBC group, whereas no significant increase was found in ICGC group. Right ventricular stroke work index significantly increased only in CWBC group as well. In CWBC group, myocardial oxygen and lactate extraction rates were maintained within normal range during aortic cross-clamping, suggesting satisfactory myocardial preservation with an aerobic metabolism. In conclusion, CWBC is superior to ICGC as a myocardial protection during AVR.
Nagaoka
H
H
Department of Cardiovascular Thoracic Surgery, Tsuchiura Kyodo General Hospital, Japan.
Innami
R
R
Hirooka
K
K
Ohnuki
M
M
Funakoshi
N
N
Fujiwara
A
A
D001021:Aortic Valve / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000601:surgery; D005069:Evaluation Studies as Topic; D005260:Female; D006324:Heart Arrest, Induced / Q000379:methods*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged