[Assessment of effectiveness of a reperfusion solution in heart surgery].
Technics of myocardial protection used in cardiac surgery have been dramatically improved with the use of cardioplegic solutions. These solutions (particularly blood cardioplegic solutions) are routinely administered during open heart surgery. When unclamping the aorta, reperfusion of the ischemic heart with oxygenated blood induces reperfusion injury. Consequently, solutions capable of reducing cellular damage due to reperfusion have been designed. The effectiveness of a reperfusion solution was assessed by a randomized double-blind study including 14 patients with coronary disease. Five biochemical and physiological parameters were measured: coronary resistance, oxygen uptake, total adenine nucleotides, malonaldehyde and lactate. The solution attenuated the reperfusion phenomenon: coronary resistance remained stable, oxygen uptake was increased at the beginning of reperfusion, the pool of nucleotides was preserved and lactate production was reduced. A new study on a larger number of patients is mandatory to establish the place of this reperfusion solution in myocardial protection, particularly in the case of prolonged ischemic time.
Sabatier
B
B
Département de Pharmacie, Hôpital Broussais, Paris.
Acar
C
C
Conti
M
M
Pech
M A
MA
Dhote
P
P
Ponzio
O
O
Chevallier
A
A
Carpentier
A
A
D000227:Adenine Nucleotides / Q000032:analysis; D000368:Aged; D002314:Cardioplegic Solutions / Q000627:therapeutic use; D003331:Coronary Vessels / Q000502:physiology; D004311:Double-Blind Method; D006801:Humans; D007773:Lactates / Q000032:analysis; D008315:Malondialdehyde / Q000032:analysis; D008875:Middle Aged; D015425:Myocardial Reperfusion / Q000295:instrumentation* / Q000379:methods; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D010101:Oxygen Consumption / Q000502:physiology; D014655:Vascular Resistance / Q000502:physiology
D000227:Adenine Nucleotides; D002314:Cardioplegic Solutions; D007773:Lactates; D008315:Malondialdehyde
Evaluation de l'efficacité d'une solution de reperfusion en chirurgie cardiaque.