A study on an auxiliary technique for arch replacement under normothermic conditions without cardiac arrest

常温条件下无心脏骤停置换足弓辅助技术的研究

• 批准号: 13470277
• 负责人: KOJA Kageharu
• 金额: $ 8.19万
• 依托单位: University of the Ryukyus
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (B)
• 财政年份: 2001
• 资助国家: 日本
• 起止时间: 2001 至 2002
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-13470277/
• 关键词: Aortic arch replacement; without cardiac arrest; coronary perfusion

Aortic arch replacement requires deep hypothermic circulatory arrest(DI-ICA)and is associated with many postoperative complications.Improved surgical outcome would be anticipated if extracorporeal circulation could be achieved under normothermic conditions without cardiac arrest.The objective of the present study was to clarify the optimal conditions for such replacement surgery.[Methods]Electrocardiography(EGG), left atrial pressure(LAP), ascending aortic root pressure(Ao root Pre)and feinoral artery pressure(FAP)were monitored in beagle dogs.After initiation of F-F bypass, the ascending aorta(Asc Ao)was clamped.Monitoring was coniinued ntil animals were weaned from extracorporeal circulation(EGG).Animals were divided into two groups: those with coronary perfusion via the aortic root(2ml/mm/kg), and those without coronary perfusion.[Results]1)In all subjects in both groups, cardiac activity was maintained throughout 120 minutes of aortic clamping. 1-lemodynamics remained stable even after the clamp was released, and weaning from extracorporeal circulation was straightforward.2)in the group without coronary perfusion, left atrial pressure started to increase stalling 80 minutes after clamping, reaching a peak of 15 mmHg at 90 minutes after clainping.[Conclusions]As an auxiliary technique during arch replacement,. clamping of the ascending aorta is possible under normothermic conditions without cardiac an-est, and concurrent coronary perfusion is important for maintaining heinodynamic stability.

主动脉弓置换术需要深低温停循环（DI-ICA），并伴有许多术后并发症，如果能在常温条件下实现体外循环而不发生心脏骤停，则有望改善手术效果，本研究的目的是阐明此类置换手术的最佳条件。[方法]心电图（EGG）、左房压（LVEF）、升主动脉根部压在Beagle犬中监测Ao根Pre和胎口动脉压（FAP），在F-F转流开始后，夹闭升主动脉（Asc Ao），监测至动物脱离体外循环（EGG）。经主动脉根部冠状动脉灌注组（2 ml/mm/kg）和未经冠状动脉灌注组。[结果]1）两组受试者在主动脉阻断120 min内均保持心脏活动。1-2）无冠脉灌注组，左房压力在夹闭后80 min开始缓慢升高，夹闭后90 min达到峰值15 mmHg。[结论]作为牙弓置换术的辅助技术。在没有心脏麻醉的正常温度条件下，可以夹紧升主动脉，同时进行冠状动脉灌注对于维持血液动力学稳定性是重要的。

项目成果

Kiyoshi Iha: "Acute Aortic Dissection associated With Sheehan's syndrome"The Japanese journal of THORACIC CARDIOVASCULAR SURGERY. Vol.49, No.9. 584-586 (2001)

Kiyoshi Iha：“与希恩综合征相关的急性主动脉夹层”日本胸心血管外科杂志。

Yukio Kuniyoshi: "One stage operation for descending Thoracic Aortic Aneurysm and left Lung cancer : A case report"Ann thorac Cardiovasc surg. Vol.7, No.4. 237-240 (2001)

Yukio Kuniyoshi：“胸降主动脉瘤和左肺癌的一期手术：病例报告”安胸心血管外科。

宮城和史: "複数血管病変を有する症例の治療"日本血管外科学会雑誌. 10. 23-29 (2001)

Kazushi Miyagi：“多发性血管病变病例的治疗”日本血管外科学会杂志 10. 23-29 (2001)。

Kuniyoshi, Y: "Cooling Device for Bradycardia Based on Peltier Element for Accurate Anastomosis of Off-Pump Coronary Artery Bypass Grafting"Artificial Organs. 26(10). 827-832 (2002)

Kuniyoshi, Y：“基于珀耳帖元件的心动过缓冷却装置用于非体外循环冠状动脉搭桥术的精确吻合”人工器官。

YUKIO KUNIYOSHI: "Myocardial Prolective Effect of Hypothermia during Extracorponeal Circulation-By Quantitative Measurement of Myocardial Oxygen Consumption-"Annals of Thoracic and Cardiovascular Surgery. Vol.9,N0.3. 155-162 (2003)

YUKIO KUNIYOSHI：“体外循环过程中低温对心肌的预防作用——通过心肌耗氧量的定量测量——”胸心血管外科年鉴。