Noncardioplegic myocardial preservation for coronary revascularization

摘要: Hypothermic potassium cardioplegia has become the most popular technique for myocardial preservation during coronary revascularization. However, an older continues to yield comparable results with some potential advantages. Myocardial was achieved systemic hypothermia 28° C, pericardial cooling, elective ventricular fibrillation, maintenance of perfusion pressure between 80 and 100 mm Hg, routine left venting, local vessel isolation distal anastomoses without aortic occlusion. Proximal were performed prior atrial cannulation cardiopulmonary bypass. Nonemergency isolated bypass grafting in 500 consecutive patients, whom 51% had a infarction, 24% unstable angina, 21% main stenosis. Primary 483 patients reoperations 17. The mean number grafts per patient 3.8. Perioperative infarction occurred 1.8%. Hospital mortality 0.4%. Late follow-up obtained all survivors at postoperative interval 17.8 months. All asymptomatic or improved over their preoperative status. 3 year actuarial survival rate 95.8%, equivalent that matched general population. Of 287 male under age 65, 68.4% working preoperatively 69.5% postoperatively. This provides may be useful when occlusion administration cardioplegic solutions is not desireable.