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

主动脉弓置换术需要深低温停循环，并与许多术后并发症有关。如果能够在常温条件下实现体外循环而不发生心脏骤停，手术结果将会有所改善。[方法]对Beagle犬的心电图、左房压(LAP)、升主动脉根压(Ao Root Pre)和股动脉压(FAP)进行监测。F-F转流开始后，阻断升主动脉(ASCAO)。监测持续到动物从体外循环(ECC)断奶。动物分为两组：经主动脉根部冠脉灌注组(2ml/min/kg)和非冠脉灌注组。[结果]1)在两组受试者中，心脏活动在主动脉阻断120分钟内保持不变。即使在夹子松开后，血流动力学仍保持稳定，脱离体外循环是很容易的。2)在无冠脉灌注组，左房内压在阻断后80min开始升高，在阻断后90min达到峰值15 mm Hg。[结论]作为弓部置换术中的辅助技术，在常温条件下，无需心脏骤停即可阻断升主动脉，同时冠脉灌流对维持血流动力学稳定具有重要意义。通过本报告的制作，我们找到了关于逆行灌注的心电图和血流灌注改变的相关文献如下。

Aortic arch replacement requires deep hypothermic circulatory arrest(DHCA) 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(ECG), left atrial pressure(LAP), ascending aortic root pressure(Ao root Pre) and femoral artery pressure(FAP) were monitored in beagle dogs. After initiation of F-F bypass, the ascending aorta(Asc Ao) was clamped. Monitoring was continued until animals were weaned from extracorporeal circulation(ECC). Animals were divided into two groups: those with coronary perfusion via the aortic root(2 ml/min/kg), and those without coronary perfusion. [Results] 1)In all subjects in both groups, cardiac activity was maintained throughout 120 minutes of aortic clamping. Hemodynamics remained stable even after the clamp was released, and weaning from extracorporeal circulation was straightfonvard. 2)In the group without coronary perfusion, left atrial pressure started to increase starting 80 minutes after clamping, reaching a peak of 15 mmHg at 90 minutes after clamping. [Conclusions]As an auxiliary technique during arch replacement, clamping of the ascending aorta is possible under normothermic conditions without cardiac arrest, and concurrent coronary perfusion is important for maintaining hemodynamic stability. We find related documents like the following else,about against an electrocardiography and perfusion change for retrograde perfusioneffect by this report making.