Author | Cueva, Clotario Neptali Carrasco | |
Author | Rocha, Maiara dos Santos | |
Author | Mendes, Carlos Maurício Cardeal | |
Author | Freitas, Luiz Antonio Rodrigues de | |
Author | Baucia, José Augusto | |
Author | Badaró, Roberto José da Silva | |
Access date | 2014-06-09T14:26:26Z | |
Available date | 2014-06-09T14:26:26Z | |
Document date | 2013 | |
Citation | CUEVA, C. N. C. et al. Clinical and ultramicroscopic myocardial randomized study of beating versus arrested heart for mitral surgery. Revista Brasileira de Cirurgia Cardiovascular, v. 28, n. 2, p. 270-280, 2013. | pt_BR |
ISSN | 1678-9741 | |
ISSN | 10.5935/1678-9741.20130038 | |
URI | https://www.arca.fiocruz.br/handle/icict/7804 | |
Language | eng | pt_BR |
Publisher | Sociedade Brasileira de Cirurgia Cardiovascular | pt_BR |
Rights | open access | pt_BR |
Title | Clinical and ultramicroscopic myocardial randomized study of beating versus arrested heart for mitral surgery | pt_BR |
Type | Article | pt_BR |
Abstract | INTRODUCTION: Beating heart surgery on normothermic bypass simulates physiologic cardiac status. OBJECTIVES: This study compared clinical and transmission electron microscopic aspects of myocardial protection during mitral valve replacement using warm retrograde perfusion in empty beating versus arrested heart with cold blood anterograde cardioplegia. METHODS: Randomized study to evaluate myocardial cellular ischemia-reperfusion of both techniques to replace the mitral valve. Thirty-four patients were randomly assigned into group A (beating heart) and group B (arrested heart). The following parameters were assessed: echocardiography, blood chemistry, hemoglobin, lactate. During the surgical procedure a total of 102 myocardial biopsies were performed for ultrastructural analysis from anterior left ventricular wall: before cardiopulmonary bypass, before aortic desclamping and 10 minutes after reperfusion. RESULTS: Elevation of lactate at 3 hours during the procedure was higher in group A, but similar at the end of surgery (P=0.06). Cardioversion was necessary in 5/17 (A) vs. 13/17 (B) P=0.07. Median intraoperative systemic temperature was significantly lower in the group B compared to A (32° C vs. 36° C), P<0.001. There was no significant difference of the ultramicroscopic aspects of the heart biopsies before, during and after surgery in both groups. Cellular and mitochondrial transient abnormalities such as mitochondrial swelling, glycogen loss and cytosol swelling were detected independently of the moment of the biopsies. CONCLUSION: Myocardial protection and ultrastructural abnormalities were similar for both types of mitral valve replacement beating or arrested heart techniques. | pt_BR |
Affilliation | Universidade Federal da Bahia. Medical School. Salvador, BA, Brasil | pt_BR |
Affilliation | Universidade Federal da Bahia. Salvador, BA, Brasil | pt_BR |
Affilliation | Universidade Federal da Bahia. Instituto de Ciências da Saúde. Salvador, BA, Brasil | pt_BR |
Affilliation | Universidade Federal da Bahia. Medical School. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil | pt_BR |
Affilliation | Universidade Federal da Bahia. Medical School. Salvador, BA, Brasil | pt_BR |
Affilliation | Universidade Federal da Bahia. Medical School. Salvador, BA, Brasil | pt_BR |
Subject | Heart Arrest | pt_BR |
Subject | Induced | pt_BR |
Subject | Myocardium | pt_BR |
Subject | Mitral | pt_BR |
Subject | Valve | pt_BR |
Subject | Surgery | pt_BR |
DeCS | Ponte de Artéria Coronária sem Circulação Extracorpórea/métodos | pt_BR |
DeCS | Parada Cardíaca Induzida/métodos | pt_BR |
DeCS | Implante de Prótese de Valva Cardíaca/métodos | pt_BR |
DeCS | Valva Mitral/cirurgia | pt_BR |
DeCS | Miocárdio/patologia | pt_BR |
DeCS | Adolescente | pt_BR |
DeCS | Adulto | pt_BR |
DeCS | Biópsia | pt_BR |
DeCS | Feminino | pt_BR |
DeCS | Humanos | pt_BR |
DeCS | Ácido Láctico/sangue | pt_BR |
DeCS | Masculino | pt_BR |
DeCS | Microscopia Eletrônica de Transmissão | pt_BR |
DeCS | Meia-Idade | pt_BR |
DeCS | Valva Mitral/patologia | pt_BR |
DeCS | Miocárdio/ultraestrutura | pt_BR |
DeCS | Período Pós-Operatório | pt_BR |
DeCS | Estudos Prospectivos | pt_BR |
DeCS | Fatores de Tempo | pt_BR |
DeCS | Resultado do Tratamento | pt_BR |
DeCS | Adulto Jovem | pt_BR |