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The non-ischemic repair as a safe alternative method for repair of anterior post-infarction VSD

机译:非缺血性修复作为修复梗死前VSD的安全替代方法

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摘要

Patient's myocardium with post-infarction ventricular septum defect (VSD) is characterized by severe dysfunction. The "additive ischemia" caused by the operating process of cross-clamp ischemia and reperfusion injury, has a significant aggravation to the myocardium and overall negative impact to patient's outcome. We present a useful, safe and advantageous methodology in order to abolish "the toxic phase" of ischemia-reperfusion which is adopted by most as the "classic repair method" of myocardial protection. This abolition is in our opinion, particularly beneficial in order to reverse postoperatively the Low Cardiac Output Syndrome (LOS) and achieve better short and long term results. By using this method we avoid the aortic occlusion, the use of systematic hypothermia and any cardioplegic arrest. Furthermore, the total cardio-pulmonary bypass (CPB) time is significantly reduced, tissue debridement and stitching is much easier and safer. We think the method is applicable for every anterior and apical case of post-infarction septum rupture. After application of method in 3 patients with anterior post-myocardial infarction VSD, we are convinced that the patient will have a better postoperative haemodynamic condition and therefore a better outcome.
机译:具有梗塞后室间隔缺损(VSD)的患者心肌的特征在于严重功能障碍。由交叉钳夹缺血和再灌注损伤的操作过程引起的“加成性缺血”对心肌有显着加重作用,并且对患者的结果总体上具有负面影响。我们提出了一种有用,安全和有利的方法,以消除缺血再灌注的“毒性阶段”,该阶段被大多数人用作心肌保护的“经典修复方法”。我们认为,这种废除特别有利于术后逆转低心输出量综合征(LOS)并取得更好的短期和长期效果。通过使用这种方法,我们避免了主动脉阻塞,系统性体温过低和任何心脏停搏。此外,心肺旁路手术(CPB)的总时间显着减少,组织清创和缝合更容易,更安全。我们认为该方法适用于梗死后中隔破裂的每个前,后病例。在3例心肌梗死后前VSD患者中应用该方法后,我们确信该患者将具有更好的术后血流动力学状况,因此结果更好。

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