心脏不停跳及浅低温体外循环下心瓣膜替换术40例报告

目的：对心脏不停跳、浅低温体外循环下行心脏瓣膜替换术中相关的心肌保护、空气栓塞等问题进行探讨。方法：常规建立体外循环，维持全身浅低温32-33℃；心脏缓慢跳动，进行二尖瓣替换；若行主动脉瓣替换，则钳火主动脉的同时，进行冠状静脉窦逆灌，维持心脏缓慢跳动。结果：40例手术全部成功，无术后脑部并发症及低心排并发症。结论：采用这种新技术能够在术中对心肌进行良好的保护，术中空气栓塞是可以避免的。

Heart valve replacement on beating heart with mild hypothermia and cardiopulmonary bypass

Objective: Forty cases of cardiac valve replacement on beating heart with mild hypothermia and cardiopulmonary bypass were performed and the related issues with myocardioprotective effect and air embolism during surgery investigated. Methods: Conventional cardiopulmonary bypass was established, the body temperature was maintained at 32～33℃, and the mitral valve replacement was performed on slow beating heart.The arotic valve replacement was performed under coronary sinus retrogade perfusion on beating heart with the aorta cross-clamped Results: There was no operative mortality. Air embolism and low output syndrome were avoided. Conclusion: Through our practice, we think an optimal myocardioprotective effect during surgery could be made by this new technique, and air embolism could be avoided if a proper method of expelling is used.