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Ann Thorac Surg 1976;21:123-130
© 1976 The Society of Thoracic Surgeons

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Articles

Myocardial Protection during Aortic Valve Replacement

From the Department of Surgery (Thoracic), UCLA Medical Center, Los Angeles, CA.

Accepted for publication May 9, 1975.

^* Address reprint requests to Dr. Mulder, Department of Surgery (Thoracic), UCLA Medical Center, Los Angeles, CA 90024

The results following aortic valve replacement (AVR) were compared in 40 patients in whom the myocardium was protected by topical hypothermic arrest or continuous coronary perfusion with sustained electrical fibrillation (Group A) and 40 similar patients in whom the hearts were also continuously perfused but were kept in the beating state (Group B). The operative mortality was not greatly different between the two groups, being 10 and 5%, respectively.

The postperfusion cardiac performance was strikingly different, however. Seventeen patients (43%) in Group A required inotropic support, while this was necessary in only 1 patient (3%) in Group B. In this instance, recurrent ventricular fibrillation persisted despite attempts at reversion.

These data show that the myocardium is preserved best during AVR when continuous coronary perfusion is used and the heart is maintained in the beating state.

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