Abstract:

BACKGROUND: Myocardial damage caused by open heart surgery involving cardiopulmonary bypass (CPB) is one of the most common causes of postoperative complications. On-pump beating-heart technique with mild hypothermia is benefit to the high-risk patients due to its myocardial protective effect.
OBJECTIVE: To investigate myocardial protective effects of on-pump beating-heart technique with mild hypothermia on elderly patients undergoing valve replacement with CPB.
METHODS: Thirty elderly patients undergoing elective artificial heart mitral valve replacement with CPB were eligible for inclusion in the study. The patients were divided into two groups according to the treatment method: in the control group, the heart valve replacement was completed under moderate hypothermia, and in the beating heart group, the heart valve replacement was completed under mild hypothermia.
RESULTS AND CONCLUSION: Compared with before CPB, the concentration of tumor necrosis factor-alpha, interleukin 6, interleukin 8 and cardiac troponinⅠwere increased at 30 minutes after the start of CPB, and before the right atrium was closed during operation (P < 0.05), and the changes were obvious in control group (P < 0.05). The expression of nuclear transcription factor kappa B was increased when the right atrium was closed, but the increased expression of nuclear transcription factor kappa B in beating heart group was smaller in the two groups (P < 0.05). On-pump beating-heart technique with mild hypothermia can significantly decrease the myocardial damage in open heart operation with CPB in elderly patients which may relate with the decreasing of the myocardial inflammatory response.