Mitral Valve Surgery Under Perfused Ventricular Fibrillation With Moderate Hypothermia
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概要
- 論文の詳細を見る
The safety and myocardial protective effect of perfused ventricular fibrillation (VF) under moderate hypothermia were investigated. Through a midline sternotomy and opening the left atrium from the right side, isolated mitral valve surgery was performed under aortic cross-clamping (ACC) and cardioplegic arrest using Bretschneider HTK solution in 96 patients, and under perfused VF in 20 patients (VF Group). Patient characteristics, clinical outcomes, and perioperative variables were compared. A satisfactory surgical view was obtained in all VF Group patients. Patient characteristics in the 2 groups were similar, and both groups had comparable results for mortality and morbidity, operation time, cardiopulmonary bypass time, peak levels of creatine kinase (CK) and its myocardial fraction, hours of mechanical ventilation, intensive care unit stay, and postoperative left ventricular ejection fraction. Even in VF Group patients with preoperative critical hemodynamic compromise, inotropes could be discontinued within 3 days. Thus, no detrimental effect of perfused VF was observed. On the other hand, in patients who underwent ACC and cardioplegic arrest of 120 mm or longer, peak levels of CK and its myocardial fraction were significantly higher than those of the rest of C group patients and VF Group patients. Perfused VF under moderate hypothermia can be a good alternative myocardial protection strategy during mitral valve surgery, particularly in patients in whom ACC is unsuitable or the duration of ACC is expected to be long.
- 社団法人日本循環器学会の論文
- 2002-04-20
著者
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KYO Shunei
Department of Cardiothoracic Surgery, The University of Tokyo
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荻原 正規
公立昭和病院心臓血管外科
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ASANO Haruhiko
Department of Hematology and Oncology, Nagoya University Graduate School of Medicine
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Tanabe Hiroaki
Department of Cardiovascular Surgery, The Cardiovascular Institute Hospital
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Tanabe Hiroaki
Department Of Cardiovascular Surgery Saitama Medical School
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GOJO Satoshi
Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of
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Kyo Shunei
Department Of Cardiovascular Surgery Saitama Medical University
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Kyo Shunei
Department Of Cardiac Surgery Saitama Medical School
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Gojyo Satoshi
Department Of Cardiovascular Surgery Saitama Medical University
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Gojo Satoshi
Department Of Cardiovascular Surgery Saitama Medical Center
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Kato Masaaki
Department of Cardiovascular Surgery, Morinomiya Hospital
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Ohuchi Hiroshi
Department Of Cardiovascular Surgery Saitama Medical School
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Asano Haruhiko
Department Of Cardiovascular Surgery Saitama Medical School
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Kato Masaaki
Department Of Cardiovascular Surgery Saitama Medical School
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Imanaka Kazuhito
Department of Cardiovascular Surgery, Kawagoe Medical Center, Saitama Medical University
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YOKOTE YUJI
Department of Pediatric Cardiology and Cardiovascular Surgery, Saitama Heart Institute, Saitama Medi
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Ogiwara Masanori
Saitama Medical School
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OGIWARA Masanori
Department of Cardiovascular Surgery, Saitama Medical School
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Yokota Yuji
Saitama Medical School
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Gojyou Satoshi
Department Of Cardiovascular Surgery Saitama Medical University
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Kyo Shunei
Fujiyoshida Municipal hospital
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Ogiwara Masanori
Department Of Cardiothoracic Surgery Saitama Medical School
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Ogiwara Masanori
Department Of Cardiovascular Surgery Saitama Medical School
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Imanaka Kazuhito
Department Of Cardiovascular Surgery Kawagoe Medical Center Saitama Medical University
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Imanaka Kazuhito
Department Of Cardiothoracic Surgery The University Of Tokyo
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Yokote Yuji
The Department Of Surgery Saitama Medical School
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Kyo Shunei
Department Of Cardiovascular Surgery Saitama Medical School
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Asano Haruhiko
Department Of Biomedical Sciences Chubu University
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Ohuchi Hiroshi
Department Of Cardiovascular Surgery
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Ohuchi Hiroshi
Department Of Cardiovascular Surgery Saitama Medical Center Saitama Medical School
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Kato Masaaki
Department Of Cardiovascular Surgery Morinomiya Hospital
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Shimomura Katusro
National Cardiovascular Center Division Of Cardiology
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