Chinese Journal of Tissue Engineering Research ›› 2011, Vol. 15 ›› Issue (5): 835-838.doi: 10.3969/j.issn.1673-8225.2011.05.018

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Lung protection of mitral valve replacement operation on beating-heart with mild hypothermic cardiopulmonary bypass

Xie Xiao-yong, He Wei, Xian Lei, Zheng Bao-shi, Feng Xu, Zhou Tao, Gao Jian-chao   

  1. Department of Cardiothoracic Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanjing  530021, Guangxi Province, China
  • Received:2010-09-05 Revised:2010-11-25 Online:2011-01-29 Published:2011-01-29
  • Contact: He Wei, Professor, Department of Cardiothoracic Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanjing 530021, Guangxi Province, China
  • About author:Xie Xiao-yong, Studying for doctorate, Associate chief physician, Department of Cardiothoracic Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanjing 530021, Guangxi Province, China xiexiaoyong_xxy@yahoo.com.cn

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Abstract:

BACKGROUND: The treatment of beating-heart with mild hypothermic cardiopulmonary bypass (CPB) may lessen lung injury after intracardiac operation underdirects vision, but mechanism of action remains unclear.
OBJECTIVE: To evaluate the lung protection of mitral valve replacement operation on beating-heart with mild hypothermic CPB.
METHODS: A total of 40 patients underwent mitral valve replacements which were randomly divided into experimental group and control group. Patients in the experimental group were performed operation on beating-heart with mild hypothermic CPB, while patients in the control group received operation on arrested heart with moderate hypothermia CPB. Bronchoalveolar lavage fluid (BALF) was collected at 30 minutes (two time points) replacement started and after CPB. The levels of tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8) and myeloperoxidase (MPO) in BALF were measured. Neutrophil was measured by left and right atrial blood respectively before CPB and 30 minutes after CPB, and then the transpulmonary polymorphonuclear was calculated. Respiratory index (RI) was calculated before CPB, at the end of CPB, 1 hour and 8 hours after CPB.
RESULTS AND CONCLUSION: The levels of TNF-α, IL-8, MPO in BALF and transpulmonary polymorphonuclear in blood at 30 minutes after CPB were significantly increased in experimental group and control group (P < 0.01). But levels of those in the experimental group were lower significantly than that in the control group (P  < 0.05). The levels of RI at the end of CPB, 1 hour and 8 hours after CPB were significantly increased in two groups (P < 0.05), but the level in the experimental group was lower significantly than that in the control group (P  < 0.05). It is indicated that mitral valve replacement operating on beating-heart with mild hypothermic CPB can lighten lung injury and has a better effect on lung protection.

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