Single-Dose Cold Modified Bretschneider Solution for Myocardial Protection in the Surgical Treatment of Patients with Aortic Valve Stenosis and Left Ventricular Hypertrophy

Petar H. Uzov, Chavdar M. Ivanov
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Abstract

Summary Aortic valve stenosis (AS) is predominantly caused by degenerative calcification in patients over 70 years. It obstructs the left ventricular outflow tract. The result is concentric left ventricular hypertrophy (LVH) wall stress and ischemia-induced myocardial fibrosis. [1] According to the European Association of Cardiothoracic Surgery, all high-grade AS patients are indicated for Aortic valve intervention [2]. One of the most recommendable methods for myocardial protection during surgical aortic valve replacement is antegrade delivery of cold crystalloid cardioplegia. Our retrospective study included 173 operated patients with AS and LVH. We observed the MB fraction of the enzyme creatine phosphokinase (CPK-MB) as a postoperative marker for myocardial hypoprotection in different patients. Our results showed that a single dose of modified Bretschnaider solution provided safe and long enough myocardial protection during conventional and minimally invasive aortic valve replacement in patients with AS and LVH [3].
单剂量冷改良Bretschneider溶液在主动脉瓣狭窄和左心室肥厚患者手术治疗中的心肌保护作用
主动脉瓣狭窄(AS)在70岁以上的患者中主要由退行性钙化引起。它阻塞了左心室流出道。结果是同心性左室肥厚(LVH)壁应力和缺血引起的心肌纤维化。[1]根据欧洲心胸外科协会(European Association of cardithoracic Surgery),所有高级别AS患者都需要主动脉瓣介入治疗[2]。在外科主动脉瓣置换术中,最值得推荐的心肌保护方法之一是顺行输送冷晶体心脏截瘫。我们的回顾性研究包括173例AS和LVH手术患者。我们观察了肌酸磷酸激酶(CPK-MB)的MB部分作为不同患者心肌保护减退的术后标志物。我们的研究结果表明,在AS合并LVH患者的常规和微创主动脉瓣置换术中,单剂量改良Bretschnaider溶液可以提供安全且足够长的心肌保护[3]。
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