Protective Effect Of Oxygenated Lecukocyte-depleted Blood Cardioplegia On Myocardium In Patients Undergoing Valve Replacement

Objectives: To evaluate the protective effects of oxygenated lecukocyte-depleted blood cardioplegia on myocardial ischemic and reperfusion injury in patients undergoing valve replacement with cardiopulmonary bypass.Methods: Twenty patients undergoing valve replacement were randomly divided into two groups: treated group (n=10) and control group (n=10). Control group received normal oxygenated blood cardioplegia perfusion and treated group perfused with leukocyte-depleted oxygenated blood. The blood samples were taken at five different intervals, before surgery, when aortic declamping , 1 hour,4hours, 8hours after CPB, then test the levels of heart fatty acid-binding protein(HFABP) , superoxide dismutase(SOD) and malondialdehyde(MDA).At the same time , we observed and recorded some indexes of the two groups: aorta-occlusion time, the CPB time ,the dose of positive inotropic medicine used in 24 hours post operation. It was expressed in the form of x±s. And the value of P<0.05 was considered to be statistically significant .All the statistical analysis were completed by SPSS11.5.Results:There is no remarkable difference between the two groups in the aorta-occlusion time and the CPB time (P>0.05). The dose of positive inotropic medicine used in 24 hours after operation in treated group was much lower than those of control group (P < 0.05):the dose of dopamine in control group was 18.59±0.77mg/kg, and that in treated group was 8.24±0.16mg/kg; the dose of adrenaline in control group was 65.73±21.54ug/kg, that in treated group was 16.37±4.28ug/kg. After aortic declamping serum concentration of HFABP and MDA increased in both groups, and it was much higher in treated group(P﹤0.05). SOD was decreased when 1 hour,4 hours, 8 hours after CPB in both groups (P﹤0.05). The changes of SOD in leukocyte-depleted group were significantly lower than that in control group.Conclusions: This study suggests that perfusion with oxygenated lecukocyte-depleted blood cardioplegia can attenuate myocardial ischemia-reperfusion injury during open heart surgery ,and confer a direct benefit to the patients by inhibiting the reduction of SOD ,decreasing the production of MDA and HFABP.