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| Format: | Artículo científico |
| Language: | en |
| Published: |
Sociedade Brasileira de Cirurgia Cardiovascular
2013
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| Online Access: | https://www.redalyc.org/articulo.oa?id=398941889017 |
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Table of Contents:
- Clinical and ultramicroscopic myocardial randomized study of beating versus arrested heart for mitral surgery Clotario Neptali Carrasco Cueva Maiara dos Santos Rocha Carlos Maurício Cardeal Mendes Luiz Antonio Rodrigues de Freitas José Augusto Baucia Roberto Badaró Medicina Induced Surgery Myocardium Heart Arrest Mitral Valve Introduction: Beating heart surgery on normothermic by - pass simulates physiologic cardiac status. Objectives: This study compared clinical and transmission electron microscopic aspects of myocardial protection during mitral valve replacement using warm retrograde perfusion in empty beating versus arrested heart with cold blood antero - grade cardioplegia. Methods: Randomized study to evaluate myocardial cellular ischemia-reperfusion of both techniques to replace the mitral valve. Thirty-four patients were randomly assigned into group A (beating heart) and group B (arrested heart). The following parameters were assessed: echocardiography, blood chemistry, hemoglobin, lactate. During the surgical procedure a total of 102 myocardial biopsies were performed for ultrastructural analysis from anterior left ventricular wall: before cardiopulmonary by - pass, before aortic desclamping and 10 minutes after reperfusion. Results: Elevation of lactate at 3 hours during the proce - dure was higher in group A, but similar at the end of surgery ( P =0.06). Cardioversion was necessary in 5/17 (A) vs. 13/17 (B) P =0.07. Median intraoperative systemic temperature was sig - nificantly lower in the group B compared to A (32ºC vs. 36ºC), P <0.001. There was no significant difference of the ultramicro - scopic aspects of the heart biopsies before, during and after surgery in both groups. Cellular and mitochondrial transient abnormalities such as mitochondrial swelling, glycogen loss and cytosol swelling were detected independently of the moment of the biopsies. Conclusion: Myocardial protection and ultrastructural ab - normalities were similar for both types of mitral valve replace - ment beating or arrested heart techniques. 2013 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398941889017 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.2 Vol.28