Myocardial Protection for Open Heart Operation in Infancy; Experimental and Clinical Studies
| Project/Area Number |
60570633
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Thoracic surgery
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| Research Institution | Akita University |
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Principal Investigator |
ABE Tadaaki Akita University Hospital (Cardiovascular Surgery), 医学部, 教授 (30004815)
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| Co-Investigator(Kenkyū-buntansha) |
ATUMI Hiroyuki Akita University Hospital (Cardiovascular Surgery), 医学部, 助手 (60151081)
SAKURADA Tohru Akita University Hospital (Cardiovascular Surgery), 医学部, 助手 (70125714)
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| Project Period (FY) |
1985 – 1986
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| Project Status |
Completed (Fiscal Year 1986)
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| Budget Amount *help |
¥1,700,000 (Direct Cost: ¥1,700,000)
Fiscal Year 1986: ¥300,000 (Direct Cost: ¥300,000)
Fiscal Year 1985: ¥1,400,000 (Direct Cost: ¥1,400,000)
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| Keywords | Myocardial protection / Retrograde coronary sinus perfusion(RCSP) / St Thomas Hospital solution / Right ventricular function / Topical cooling |
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| Research Abstract |
After the experimental study in annimals, we started the clinical use of retrograde coronary sinus perfusion (RCSP) with the cardioplegic solution (4゜C St Thomas Hospital solution) for myocardial protection in these particular patients with aortic valve operation in which conventional selective coronary perfusion might be technically difficult. This method has made the operative procedures extremely easy and brought much better surgical results. Our present studies are aiming further application of this method to the infant open heart operations, particularly the anatomic correction of TGA (Jatene) in which operative procedures are more complicated, bringing inevitably more difficult myocardial protection.
Using the mongrel dogs, myocardial ischemia was induced by aortic crossclamping and obstruction of the left main coronary artery under CPB. After 90 minutes of ischemia, coronary arteries were reperfused by releasing the aortic crossclamp and left coronary obstruction. Myocardial temperature, Pco , pH, oxygen and lactate uptake and ATP were measured. RCSP-group showed a better myocardial cooling than the group with conventional antegrade perfusion. The rest of the experimental results also demonstrated satisfactory perfusion of the left ventricular myocardium in RCSP-group.
Thus, this method will be an excellent alternative for myocardial protection in particular open heart operation. However, occasional insufficient perfusion of the right ventricular myocardium has been pointed out to be a drawback of this method. We studied right ventricular functions of the dogs in 1) RCSP with topical cooling of the right ventricle, 2) RCSP without topical cooling and 3) conventional antegrade perfusion. Right ventricular function after 60 minutes of ischemia deminished significantly in the group of dogs in RCSP without topical cooling. This means the importance of right ventricular topical cooling at the time of RCSP.
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Report
(1 results)
Research Products
(10 results)
