ARRESTO CARDIOPLEGICO O ARRESTO ISCHEMICO? IMPIEGO DELLA SOLUZIONE DI BRETSCHNEIDER IN CARDIOCHIRURGIA

The authors compare the degree of myocardial damage caused by an aortic cross clamping 'protected' by the coronary infusion of the Bretschneider solution as cardioplegic agent with that caused by a conventional aortic cross clamping (short and with mild body hypothermia around 32°C). As myocardial damage indexes two parameters, one biochemical and the other morphologic have been studied. In the biochemical study the concentration of several enzymes (CPK, LDH, GOT, GPT, HBDH, Aldolasi), in the coronary sinus blood, has been measured. The morphologic study consisted in electron microscope observation of the right auricolar myocardium before and after the aortic cross clamping. Both studies have been carried out in two groups of patients, the first with and the second without Bretschneider, total number being 32 cases. Biochemical data have been statistically analyzed by a computer to verify their reliability. It was found that both the enzymatic concentration and the cytologic alterations were significantly lower in the cardioplegic group of patients. The authors recommend a wider use of Bretschneider solution as cardioplegic agent in cardiac surgery.