Abstract
Surgical treatment of postinfarction aneurysm is a topical problem in cardiac surgery and
involves the difficulties of the method of choice for myocardial protection. The most recognized
and widely used in the world practice is chemical cardioplegia (intracellular and extracellular
solutions) and blood cardioplegia (cold and warm).
The technique of intracellular solution «Kustodiol» provides its homogeneous distribution during
antegrade infusion even in patients with occlusions and multiple coronary bed lesions. The
peculiarity of this solution is its single dosing. Repeated infusions are required only in case of a
sudden electromechanical heart activity.
In recent decades blood cardioplegia has been widely distributed. According to many authors,
this method of myocardial protection has great advantages in comparison with other methods.
A number of researchers established that in the group of patients with reduced myocardial contractility
and who underwent the operation on a beating heart under cardiopulmonary bypass,
had fewer complications in early and late postoperative periods than in the group of patients
with hypothermic cardioplegia.
References
Бокерия Л. А., Вольгушев В. Е., Мовсесян Р. Р. Использование нормотермического кардиоплегического раствора при операции реваскуляризации миокарда // Грудная и серд.-сосуд. хир. 2006. № 3. С. 4-8.
Бокерия Л. А., Вольгушев В. Е. Нормотермическая кардиохирургия. История, достижения, перспективы // Анналы хир. 2005. № 6. С. 11-17.
Боткин Д. А., Наймушин А. В., Гордеев М. Л. Оптимизация защиты миокарда методом изотермической прерывистой кровяной кардиоплегии // Артериальная гипертензия. 2009. № 2. С. 5-9.
Вольгушев В. Е., Пискун А. В., Мовсесян Р. Р. Применение нормотермического кардиоплегического раствора при реваскуляризации миокарда у больного с низкой фракцией выброса левого желудочка // Бюллетень НЦССХ им. А. Н. Бакулева РАМН. 2006. № 5. С. 90-92.
Жидков И. Л., Белянко И. Э., Ситниченко Н. В. Влияние объема перфузий раствора «Кустодиол» на эффективность кардиоплегии в эксперименте // Анестезиол. и реаниматол. 2008. № 5. С. 10-13.
Илюхин М. А. Оценка эффективности методов доставки кардиоплегии в кардиохирургии: автореф. дис. … канд. мед. наук. М., 2009.
Abah U., Garfjeld Roberts P., Ishaq M. Is cold or warm blood cardioplegia superior for myocardial protection? // Interact. Cardiovasc. Thorac. Surg. 2012. Vol. 6. P. 848-855.
Athanausuleas C., Siler W., Buckberg G. et al. Myocardial protection during surgical ventricular restoration // Eur. J. Cardiothorac. Surg. 2006. Vol. 29. P. 231-237.
Caputo M., Santo K. C., Angelini G. D. Warm-blood cardioplegia with low or high magnesium for coronary bypass surgery: randomized controlled trial // Eur. J. Cardiothorac. Surg. 2011. Vol. 3. P. 722-729.
Casalino S., Tesler U. F., Novelli E. The efficacy and safety of extending the ischemic time with a mо- dified cardioplegic technique for coronary artery surgery // J. Cardiol. Surg. 2008. Vol. 5. P. 444-449.
DOnofrio, Cugola D., Bolgan I. et al. Surgical ventricular reconstruction with different myocardial protection strategies. A propensity matched analysis // Ann. Thorac. Surg. 2009. Vol. 73. № 2. P. 354-356.
Durandy Y., Hulin S. Intermittent warm blood cardioplegia in the surgical treatment of congenital heart disease: clinical experience with 1400 cases // J. Thorac. Cardiovasc. Surg. 2007. Vol. 1. P. 241-246.
Grocott H. P. Perioperative temperature and cardiac surgery // J. Extracorpor. Technol. 2006. Vоl. 38, № 1. Р. 78-80.
Jacob S., Kallikourdis A., Sellke F. Is blood cardioplegia superior to crystalloid cardioplegia? // Interact. Cardiovasc. Thorac. Surg. 2008. Vol. 3. P. 491-498.
Kassab G. S., Kostec M., Buckberg G. D. et al. Myocardial protection in the failing heart: II. Effect of pulsatile cardioplegic perfusion under simulated left ventricular restoration // J. Thorac. Cardiovasc. Surg. 2006. Vol. 132. P. 884-890.
Sven A. F., Tulner, Klantz J. M. et al. Left ventricular function and chronotropic responses after normothermic cardiopulmonary bypass with intermittent antegrade warm blood cardioplegia in patients undergoing coronary artery bypass grafting // Eur. J. Cardiothorac. Surg. 2005. Vol. 27. P. 599-605.
