Normothermic Coronary Perfusion during Aortic Valve Replacement
| Autor: | Joseph S. Carey, Ramon A. Cukingnan |
|---|---|
| Rok vydání: | 1978 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty medicine.medical_treatment Myocardial Infarction Body Temperature Aortic aneurysm Postoperative Complications Aortic valve replacement Internal medicine medicine.artery medicine Humans Aspartate Aminotransferases Coronary Artery Bypass Aorta business.industry Mitral valve replacement Middle Aged medicine.disease Coronary Vessels Aortic Aneurysm Perfusion Coronary arteries medicine.anatomical_structure Ventricle Aortic Valve Heart Valve Prosthesis Right coronary artery Anesthesia Ventricular Fibrillation Cardiology Mitral Valve Myocardial infarction complications Surgery Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Annals of Thoracic Surgery. 25:215-219 |
| ISSN: | 0003-4975 |
| Popis: | Normothermic coronary perfusion was used in 121 patients undergoing aortic valve replacement from 1969 to 1976. Isolated aortic valve replacement was performed in 69% of the patients (84/121), and 31% (37/121) had combined procedures consisting of aortocoronary bypass, mitral valve replacement or repair, or ascending aortic aneurysm resection in conjunction with aortic valve replacement. The left ventricle was vented in all. Sinus rhythm was maintained in 105 patients, but spontaneous fibrillation persisted in 16. Postbypass hemodynamic data indicated satisfactory ventricular performance, and postoperative morbidity and mortality were low. Postoperative myocardial infarction (new Q waves, loss of R waves, persistent S-T and T wave changes) or a serum glutamic oxaloacetic transaminase (SGOT) level of more than 100 units (colorimetric) occurred in 13% of isolated and 27% of combined procedures. In patients with electrocardiographic and SGOT changes suggesting myocardial damage and in those with persistent spontaneous fibrillation, coronary perfusion was technically unsatisfactory owing to either excessive flow, low flow, inability to perfuse the right coronary artery, or high perfusion pressures. Evidence of myocardial damage was absent when coronary perfusion was appropriately applied. In order to obtain satisfactory results with normothermic coronary perfusion, both coronary arteries must be perfused at total flow rates of 200 to 350 ml per minute and at mean pressures of less than 120 mm Hg. |
| Databáze: | OpenAIRE |
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