Amaç: Bu çalişmada rutin kullanilan kan kardiyoplejisi ile deferoksaminli kan kardiyoplejisinin sol ventrikül
fonksiyonlari üzerine etkileri, myokardiyal Nitrik Oksit (NO) düzeyleri ve hemodinamik parametreler
karşilaştirilarak değerlendirildi.
Yöntem: Aortakoroner bypass operasyonu olan 20 elektif hasta üzerinde çalişma yapildi. Hastalar kontrol ve
çalişma grubu olarak 10 ar kişilik 2 gruba ayrildi. Kontrol grubunda yaş ortalamasi (61.30+2.12), çalişma grubunda
ise (53.20±3.21) idi. Her iki grupta distal anastomoz , X- klemp, Kardiyopulmoner bypass (CPB) süreleri
benzer değerlerdeydi (p>0.05). Kardiyopleji iki gruba da antegrad yoldan verildi. Kan örnekleri koroner sinüsten
alinarak ölçümler yapildi. Hemodinamik parametreler CPB öncesi ve sonrasinda ayri ayri değerlendirildi.
Bulgular: Çalişma grubunda NO düzeyleri tüm örneklemelerde yüksek bulundu ancak yalnizca CPB sonrasinda
istatistiksel olarak anlamli idi. Myokard hasarinin bir göstergesi olan kreatin kinaz MB izoenzim (CK-MB)
değerleri çalişma grubunda daha düşük düzeyde bulundu (p< 0.05). Her iki grup arasinda hemodinamik olarak bir
farklilik gözlenmedi.
Sonuç: Bu bulgular, deferroksaminli kan kardiyoplejisi kullanilan vakalarda endotel fonksiyonlarinin daha iyi
korunduğunu ve myokard hasarinin daha az olduğunu göstermektedir. Deferroksaminli kan kardiyoplejisi açik
kalp cerrahisinde aortik kross klemp esnasindaki myokard korunmasinda iyi bir seçenektirObjective: The effects of deferroxamine addition to routine blood cardioplegia on left ventricular function,
myocardial nitric oxide (NO) production and hemodynamics were assessed.
Methods: Twenty patients who underwent coronary artery bypass grafting (CABG) electively were studied in
two groups, 10 in each. Ten patients in whom routine blood cardioplegia was used served as controls. In the other
10 patients (study group), blood cardioplegia with deferroxamine was used. Mean age was 61.30+2.12 in the
control group, and 53.20±3.21 in the study group. The number of distal anastomoses, X-clamp and cardiopulmonary
bypass (CPB) times were similar in two groups. Cardioplegia was delivered antegradely in both groups.
Blood samples were taken from the coronary sinus. Hemodynamic measurements were done before and following
CPB.
Results: In the study group, myocardial NO levels were found to be higher at all sampling times, however, the
difference was statistically significant only following CPB. Creatine kinase MB isoenzyme levels reflecting the
degree of myocardial injury were measured lower in the study group postoperatively(p<0.05). There was no
difference in hemodynamics between the two groups.
Conclusions: These findings demonstrate that the addition of deferroxamine to blood cardioplegic solution
maintains higher myocardial NO levels indicating better endothelial function and causes less myocardial injury.
Blood cardioplegia with deferroxamine is a valuable alternative method of myocardial protection during aortic
cross clamping in cardiac surgery
