Chinese Med J Peking
-
Chinese Med J Peking · Mar 1995
Randomized Controlled Trial Clinical TrialMorphometric evaluation on myocardial protection of cold crystalloid versus warm blood cardioplegia.
Twenty patients undergoing open-heart valve replacement were divided randomly into two groups in this study; intermittent perfusion of cold crystalloid (St. Thomas Hospital solution) with hypothermic cardiopulmonary bypass (CPB) (hypothermic group) and continuous administration of warm blood cardioplegia with normothermic CPB (normothermic group) respectively. Tissue samples were taken from the right atrium before weaning from CPB and from the right appendage 30 minutes after removal of the cross-clamp. ⋯ It seemed that the volumes of the mitochondria were larger in the warm group than in the cold one. Probably the results were due to more severe damages of the mitochondrial membranes in the hypothermic group, which led to the release of the contents out of the mitochondria while in the normothermic group, the sodium-pump was disordered and it made the mitochondria swell. Pathologically, blood cardioplegic perfusion with the use of normothermic CPB is a feasible method for myocardial protection in open-heart surgery.