OBJECTIVE To observe the variations of the function of endothelial cell and coronary artery resistance(CAR) during heart arrest with warm blood cardioplegia with or without aprotinin.METHODS 40 patients suffered rheumatic heart disease were selected randomly.20 of them were administered aprotinin during extracorporeal circulation(ECC) as group B(study group),others without apotinin as group A(control group).The blood samples were taken at aortic clamping,30min,60min after aortic clamping,and end warm blood perfusion.The tissue-plasminogen activator(t-PA),the qlatelet granulate membrane protein 140(GMP140) and the 6-keto-PGF1α(6-K-F1α),circulating endothelial cell(CEC)were observed.The pressure and flux were recorded during warm blood cardioplegia.RESULTS ECC led CEC to increase,which peaked at 60min after aortic crossclamp.The EC related proteins increased at that time,but the peak of 6-K-F1 in group A delayed than that in group B.CAR of group B was significantly lower than that of group B at 60 min after aortic crossclamp.CONCLUSION ECC leads to excessive activation,injury and dysfunction of EC,while aprotinin can attenuate this process.
主动脉弓中断(IAA)是一种少见的先天性心血管畸形[1,2],本例患儿在体外循环下做了一期根治术,现将其体外循环方法介绍如下.
Objective The development and application of XG-1 blood perfusion cardioplegia system(BCS) was reported. Methods The BCS was designed as reverse U type, its main part-heat exchanger could bear 552kPa. The characteristics of this BCS were quickly increasing and decreasing temperature, decreasing rate 3 ℃/min, increasing rate 2 ℃/min. Clinical application in 171 patients with severe illness, aged 1.5～68 years, body weight 9～86 kg. The cardiopulmonary bypass(CPB) time and aortic cross-clamping time were 31 min 5 s～268 min and 60 min 50s～207 min respectively. Results This system provides multifunctions eg. oxygenation blood, cardioplegia solution, measuring of temperature and pressure, filtration. It has reliable effect on protecting myocardium. All the patients were recovered and discharfed, their cardiac function were well restored and few of low cardiac output was found. Conclusion The BCS is designed reliably in advanced technique. It is easy to use with good effect on protecting myocardium.
