The Effect Of Continuous Warm Blood Cardioplegia Perfusion On Ischemia Modified Albumin In Cardiac Valve Replacement Surgery

ObjectiveTo investigate the myocardial protection effect of continuous warm blood cardioplegia perfusion in ischemia modified albumin in cardiac valve replacement and provide the basis for clinically choosing a better myocardial protection method.MethodsPatients underwent cardiac valve replacement surgery were enrolled in the study.22patients in the experimental group (A), of which7were males and15females. With in these22patients, mitral valve replacement in6cases, mitral valve replacement+tricuspid valvuloplasty in6cases, aortic valve replacement in2cases, mitral valve replacement+aortic valve replacement in3cases, double-valve replacement+tricuspid valvuloplasty in5cases, intraoperative continuous warm blood cardioplegia perfusion was used.24patients in the control group (B),8males and16females and2deaths interrupt follow-up study. With in the remaining22patients, mitral valve replacement surgery in8cases, mitral valve replacement+tricuspid valvuloplasty in5cases, aortic valve replacement in3cases, mitral valve replacement+aortic valve replacement in4cases, double-valve replacement+tricuspid valvuloplasty in4cases, traditional cold-blooded intermittent perfusion were used intraoperatively. The level of LDH、LDH-1、CK、CK-MB and HBDH were detected before the operation. The content of ischemia modified albumin (IMA) serum was also be tested by albumin cobalt binding test (ACB test). Indicators mentioned above were detected at5minutes,30minutes after aorta clamp, at the moment before aortic cross-release and after stopping cardiopulmonary bypass, and at the1day,3days and5days after surgery. Then make a comparison between the Group A and B.ResultsThe content of IMA (ACB)in the Group A at30min after aorta block and the moment before opening the aorta and after stopping cardiopulmonary bypass was48.54±2.93U/mL,48.35±3.57U/mL,51.83±3.36U/mLrespectively. Group B was41.32±1.73U/mL,42.09±2.34U/mL,46.94±2.73U/mL respectively. Group A was lower than that in the Group B significantly(p<0.05). The level of LDH、LDH-1、 CK、CK-MB and HBDH in the serum in the Group A was lower than Group B statistically at the1day and3days after the operation. The fifth day after the operation only CK serum content of group A less than group B patients. Auxiliary cycle time (min) in group A was28.18±7.92and group B was34.23±8.07. Group A was significantly lower than group B. The patients in group A with heart automatically resuscitation rate was81.82%and the patients in group B with heart automatically resuscitation rate was27.27%. Group A was significantly higher than group B. Intubation time (h) in group A was32.00±13.28and intubation time (h) in group B was40.77±12.77. Group A was significantly lower than group B.ConclusionContinuous warm blood cardioplegia perfusion with less myocardial cell damage,It can decrease the content of ischemia modified albumin.