The Search Of Energy Metabolism About The Heart Not Stopped Open-Heart Surgery

Rheumatic heart disease (RHD) is one of clinical common disease, With mitral stenosis (MS) are the most common, once the degree about heart valve disease is aggravating, timely surgery for the treatment is the most main measures, at present heart surgery mainly depends on the balloon expansion and by virtue of extracorporeal circulation (Cardio-pulmonary Bypass, CPB) machine. But open-heart surgery under CPB inevitably cause certain effect damageon in myocardial and systemic organ, which is not conducive to the recovery of postoperative patients with organ function. In this context, people began to explore different myocardial protection methods influencing on the body, the study found that on pump beating heart intracardiac procedures In mild hypothermicdoes not exists Existmyocardial ischemia-reperfusion injury in theory, and is closer to the physiological state. It has the good protective effectiveness in myocardium and it has drawn great attention in clinical [1,2], but in terms of the body’s energy metabolism, there is little research in domestic. During the period of june 2013 to August 2014, in the first affiliated hospital of guangxi medical university Congenital heart disease orthopedics were under two-phase heterogeneous surgical methods of beating heart CBP in mild hypothermia and arrested hear CBP,then to detect the plasma metabolites, compare the two kinds of different operative methods, to explore the effects of surgery on glucose metabolism, lipid metabolism and amino acid metabolism.Objective:To explore impacts of beating heart intracardiac surgery in mild hypothermia on the body’s energy metabolism. Methods:40 patients with the standard, were randomly divided into experimental group (heart kept jumping) and the control group (cardiac arrest). Collecting 5ml blood in the eight points (Tl:after the success of the preoperative peripheral arterial puncture, T2:after the success of the anesthesia induction, T3:CPB cooled to 32-33 ℃, T4:at the end of CPB, T5, T6, T7, T8 respectively were after CPB 3 h,24 h and 48 h,72 h) of the surgery process, and to get plasma by centrifugalization in turn, and then to get plasma concentrations of metabolites through the application of NMR metabonomics analysis and data processing.Such as lactic acid, ketone body, creatine, lipid, a-ketoglutaric acid, valine, tyrosine, phenylalanine, adenosine triphospha-te (ATP) concentration, etc, at the same time observing clinical effects of all patients. Results:In the data of two group patients, the dosage of dopamine and ICU stay time exist obvious difference, there were significant differences between groups, with statistical significance (P<0.05); In addition, sugars, lipids and metabolites value of proteins were present some extent of rise or fall during perioperative period.By comparison of two groups of data, there were significant differences between groups, with statistical significance (P< 0.05).Conclusion:The study shows that in the process of CPB surgery, beating heart intracardiac surgery in mild Hypothermia is more similar to the state of physiological function of the body, has less effect on the body energy metabolism, can make the body’s energy balance more relatively stable.