Effectiveness of Cardioplegic Solution in Protecting Ischemic Myocardium in Open-Heart Surgery – Clinical and Electron-Microscopic Evaluation

Year 1981, Volume: 34 Issue: 4, 607 - 620, 31.12.1981

Ali Ersöz

Abstract

Bu çalışmada, açık kalb cerrahisi sırasında uygulanan potasyum içeren kardiyoplejik solüsyonun iskemik miyokardı korumadaki etkinliği araştırılmıştır. Farklı tanılara sahip 20 olguda selektif soğutma ve buz tatbiki ile +4℃’ye kadar soğutulmuş Isolyte bazlı potasyum, magnezyum ve prokain içeren kardiyoplejik solüsyon uygulanmış; ameliyat öncesi ve iskemi sonunda alınan miyokard biyopsileri elektron mikroskop ile değerlendirilmiştir. Ortalama iskemi süresi 25–82 dakika arasında değişmekte olup; mitokondri, nükleus, glikojen ve miyofibril yapılarında bozulma gözlenmemiştir. Klinik olarak hastaların çoğunda ritm kendiliğinden sağlanmış, erken dönem komplikasyon izlenmemiştir. Sonuç olarak kullanılan solüsyonun iskemik miyokard dokusunu etkin biçimde koruduğu ve güvenle kullanılabileceği saptanmıştır.

Keywords

kardiyopleji , açık kalb cerrahisi , potasyum solüsyonu , miyokard iskemi , hipotermi , elektron mikroskopisi , miyokard korunması

Açık Kalb Cerrahisinde İskemik Miyokardın Korunmasında Kardiyoplejik Solüsyonun Etkinliği – Klinik ve Elektron-Mikroskobik Değerlendirme

Abstract

This study investigates the effectiveness of potassium-based cardioplegic solution in protecting ischemic myocardium during open-heart surgery. Twenty patients undergoing surgery with various diagnoses received selective myocardial cooling with cold perfusion and topical ice application using an Isolyte-based cardioplegic cocktail containing potassium, magnesium, and procaine. Myocardial biopsies obtained before and after ischemia were evaluated by electron microscopy. Despite ischemic periods ranging from 25 to 82 minutes, mitochondrial structure, nuclear morphology, glycogen reserves, and myofibril integrity remained preserved. Clinically, most patients resumed normal rhythm spontaneously. The study concludes that the applied cardioplegic solution effectively preserves myocardial ultrastructure and can be safely used in extended ischemic procedures.

Keywords

cardioplegia , open-heart surgery , potassium solution , myocardial ischemia , hypothermia , electron microscopy , myocardial preservation

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