COLD BLOOD CARDIOPLEGIA AND WARM CARDIOPLEGIC REPERFUSION IN HEART-TRANSPLANTATION

被引:13
作者
SOOTS, G
CREPIN, F
PRAT, A
GOSSELIN, B
POL, A
MOREAU, D
DEVULDER, JP
机构
[1] Hôpital Cardiologique, University of Lille
关键词
HEART TRANSPLANTATION; MYOCARDIAL PROTECTION; COLD BLOOD CARDIOPLEGIA; REPERFUSION;
D O I
10.1016/1010-7940(91)90183-K
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The major cause of early death after heart transplantation is graft failure. In 99 consecutive heart transplantations two protocols of myocardial protection were employed. In group 1 (n = 38) initial cold crystalloid cardioplegia combined with cold saline storage and peroperative surface cooling was used. In group 2 (n = 61) cold crystalloid cardioplegia was injected initially and cold blood cardioplegia (Buckberg) was infused every 30 min as soon as the graft arrived in the operating room. No surface cooling was used. Warm blood cardioplegic reperfusion was administered before removal of the aortic clamp. There were 8 early (within 30 days) deaths in group 1 and 6 in group 2 patients. In group 1 there were 5 cardiac deaths against 3 in group 2. Mean ischemic time was 153 +/- 37 min in group 1 and 158 +/- 51 min (p > 0.05) in group 2. The post-transplantation need for catecholamines was ten times higher in group 1 patients than in group 2. The first endomyocardial biopsy (after 1 week) showed cytologic lesions compatible with ischemia in 40% of group 1 and only 9% in group 2 patients. We conclude from this initial experience that intermittent cold blood cardioplegia and warm blood cardioplegic reperfusion are useful in heart transplantation in restoring the damage suffered by the graft during brain death and graft storage.
引用
收藏
页码:400 / 405
页数:6
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