乳児期早期開心術症例に於ける, 2時間以上の大動脈遮断の経験とその心筋保護手段

概要

論文の詳細を見る
Blood containing cardioplegic solution with low ionized calcium level was prepared independently of pump-oxygenator perfusate blood, so as to contain invariable concentration of each composite at any time. Using this solution, open heart surgery combined with prolonged aortic cross-clamping time ranging from 117 to 184 minintes(mean: 149) was performed for 7 young infants with complete transposition of the great arteries(TGA) with the median age of two months(34 days-3 months). Four patients in age of 39 days, 41 days, 2 months, 3 months survived and showed uneventful postoperative hemodynamics. Two dead patients had no indications for Jatene's anatomic repair due to their low left ventricular pressures. Another dead infant with large ventricular septal defect of muscular type showed postoperative residual shunt and its cause of death could not necessarilly imputed to the myocardial protection. Judging from these experiences of four survivors undergoing prolonged aortic clamp times ranging from 117 to 160 min in early infancy, our cardioplegic solution and its administrationtechnique could be considerably promising and expectant for young infants heart surgery.
日本小児外科学会の論文
1987-02-20