Immediate functional recovery and avoidance of reperfusion injury with surgical revascularization of short-term coronary occlusion.
Immediate functional recovery and avoidance of reperfusion injury with surgical revascularization of short-term coronary occlusion.
复制标题
通过短期冠状动脉闭塞的手术血运重建可立即恢复功能并避免再灌注损伤。
作者：
Jakob Vinten;T. Edgerton;Harold R. Howe;P. Gayheart;Stephen A. Mills;George Howard;Cordell Ar
在冠状动脉闭塞的实验准备中，急性缺血心肌的手术血运重建的功能恢复与非手术的功能恢复还没有比较。本研究比较了通过恢复冠状动脉通畅（模拟非手术再通，例如，血管成形术）或用多剂量低温钾血心脏停搏液进行外科血管重建。在22只麻醉开胸犬体内植入Millar微压计头端导管，测量左心室和主动脉压。在冠状动脉左前降支供血的内膜下植入压电超声测量器，测量节段性收缩功能。在5只犬中，仅获得活检样本用于ATP、磷酸肌酸和组织含水量的对照测量。其余17只犬结扎左前降支及侧支1 h，8只犬取下结扎线，继续冠脉灌注2 h，模拟非手术再灌注。其余9只犬进行心肺转流术，用谷氨酸盐和天冬氨酸盐增强的多剂量（每20分钟）血液心脏停搏液将心脏停搏1小时，模拟手术血运重建（冠状动脉旁路移植术）。直到第二次心脏停搏液输注时才释放冠状动脉结扎线，模拟移植物放置。1小时的冠状动脉闭塞使39.4 +/- 2.5%的左心室处于危险中，并将主动收缩期缩短转化为持续的反常膨胀（25.2 +/- 2.2%至-5.8 +/- 1.2%收缩期缩短）。（250字处删节）
Functional recovery with surgical revascularization of acutely ischemic myocardium has not been compared with its nonsurgical counterpart in experimental preparations of coronary occlusion. This study compares the functional and metabolic recovery of ischemic (1 hr coronary occlusion) segments revascularized either by restoration of coronary patency (simulating nonsurgical recanalization, e.g., angioplasty) or by surgical revascularization with multidose hypothermic potassium blood cardioplegic solution. Twenty-two anesthetized open-chest dogs were instrumented with Millar micromanometer-tip catheters to measure left ventricular and aortic pressures. Piezoelectric ultrasonic dimension gauges were implanted in the subendocardium supplied by the left anterior descending coronary artery to measure segmental contractile function. In five dogs, only biopsy samples were obtained for control measurements of ATP, creatine phosphate, and tissue water content. In the remaining 17 dogs, the left anterior descending artery and collaterals were ligated for 1 hr. The ligatures were removed in eight dogs and coronary perfusion continued for 2 hr, simulating nonsurgical reperfusion. The remaining nine dogs were placed on cardiopulmonary bypass and the hearts were arrested for 1 hr with multidose (every 20 min) blood cardioplegic solution enhanced with glutamate and aspartate, simulating surgical revascularization (coronary artery bypass grafting). The coronary ligatures were not released until the second cardioplegic infusion, simulating graft placement. One hour of coronary occlusion placed 39.4 +/- 2.5% of the left ventricle at risk, and converted active systolic shortening to persistent paradoxical bulging (25.2 +/- 2.2% to -5.8 +/- 1.2% systolic shortening).(ABSTRACT TRUNCATED AT 250 WORDS)
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通过再灌注挽救心肌的长期异常。
DOI：
10.1152/ajpheart.1981.241.4.h591
发表时间：
1981
期刊：
The American journal of physiology
影响因子：
--
作者：
Kloner,RA;DeBoer,LW;Darsee,JR;Ingwall,JS;Hale,S;Tumas,J;Braunwald,E
通讯作者：
Braunwald,E
长时间用心脏停搏液钳夹主动脉的安全性。
DOI：
--
发表时间：
1984
期刊：
The Journal of thoracic and cardiovascular surgery
影响因子：
--
作者：
Rosenkranz,ER;Okamoto,F;Buckberg,GD;Vinten-Johansen,J;Robertson,JM;Bugyi,H
通讯作者：
Bugyi,H
通过暂时改变再灌注液钙、钾、pH 值和渗透压来减少缺血后损伤。
DOI：
--
发表时间：
1981
期刊：
The Journal of thoracic and cardiovascular surgery
影响因子：
--
作者：
Follette,DM;Fey,K;Buckberg,GD;HellyJr,JJ;Steed,DL;Foglia,RP;MaloneyJr,JV
通讯作者：
MaloneyJr,JV
参与挽救缺血心肌的因素：动脉血再灌注的影响。
影响因子：
37.8
作者：
Jennings,RB;Reimer,KA
通讯作者：
Reimer,KA