心脏移植的供心切除及心肌保护

目的总结心脏移植的供心切除及心肌保护。方法 6例终末期扩张型心肌病移植,1例风湿性心脏病联合瓣膜病变晚期。前3例供心缺血时间采用4℃改良st.Thoms液顺行灌注快速心脏停搏,取出心脏后再灌注st.Thoms液1000ml,然后置4℃生理盐水浸泡保存、运输。后4例供心缺血时间采用4℃UW液（unives-risty of Wisconsin solution）。取出心脏后,再灌注UW液1000ml,在4℃UW液内保存、运输。结果 7例心脏移植完毕后,6例心脏自动复跳,1例电击复跳,术后心脏功能恢复好,未出现低心排综合征。术后1月左心室射血分数（LVEF）恢复到60%~65%。结论此方法可获得良好的供心心肌保护。

Excision and Myocardial Preservation of Donor Hearts in Heart Transplantation

Objective To summarize the excision and myocardial preservation of the donor hearts in the heart transplantation.Methods Six patients with dilated cardiomyopathy in final stage,1 patient with rheumatic heart disease combinated with valvular heart disease in advanced stage.The ischemia time of the donor hearts of the first 3 patients,we use upgrade st.Thoms antegrade perfusion to make the hearts stop striking quickly.After the donor hearts have been excisied out 1000ml st.Thoms were reperfused again.Then the hearts were preserved and transported in 4℃Sodium Chloride.The UW was used for the later four donor hearts during ischemia time.1000ml UW was reperfused again after the heart were taken out.Then the hearts were preserved and transported in 4℃UW.Results After heart transplantation for the 7 patients,6 patients＇ hearts beated again voluntarily,and 1 patient＇s heart beated again by electrization.After the operation,the functional recovery of the hearts was fine and there is no one that appeared low heart effluence syndrome.The hearts＇ LVEF were recovered to 60%～65%.Conclusion The method can gain satisfactory myocardial preservation of the donor hearts.