Comparison Of Myocardial Protection Between HTK Solution And Blood-Containing St. Thomas Solution In Heart Valve Surgery

Objective Cardiac arrest fluid plays a very important role in myocardial protection during cardiac arrest surgery under cardiopulmonary bypass.There are many kinds of cardiac arrest fluid and the mechanism of cardiac arrest is different.In this experiment,by detecting the expression of genes that rapidly respond to cell damage and some clinical indicators,the myocardial protection effect of HTK solution and blood St.Thomas solution in cardiac valve surgery under cardiopulmonary bypass was evaluated.Method This experiment what is a prospective,non-random,single-blind controlled experiment is single blind for those who measure the outcome of the experiment.Patients(40 patients)who underwent a valve surgery by median open thoracocardiac in Cardiac Surgery,Affiliated Hospital of Qingdao University from August 2018 to October 2019 were divided into HTK group(20 patients)and blood St.Thomas group(20 patients).During the course of treatment,the two groups of patients have different anesthesia methods except for the use of myocardial protection solution(HTK solution group uses HTK solution as myocardial protection solution and St.Thomas solution contains blood St.Thomas solution as myocardial protection solution).The establishment of cardiopulmonary bypass,cardiopulmonary bypass implementation,vital signs monitoring and other aspects of unified standards.Result There is no difference in the distribution of men and women in the preoperative basic data of patients in the HTK liquid group and the blood-containing St.Thomas liquid group,and there is no statistical difference in data such as age,weight,and height(P> 0.05);There is no difference in the proportion of tremor and other diseases(P> 0.05);the hemoglobin content and cardiac function evaluation indexes of the two groups of patients also meet the principle of homogeneity(P> 0.05).In the intraoperative data of the patients in the HTK solution group and the cold blood St.Thomas solution group,there was no statistical difference in the aortic occlusion time between the two groups(P> 0.05),and the number and difficulty of the surgical valves were also very close(P > 0.05).In the postoperative observation indicators,there was no difference in the expression of c-fos geneand ATF6 gene in the myocardium before the inferior vena cava block in the HTK solution group and the blood-containing St.Thomas solution group(P> 0.05);The expression levels of c-fos gene and ATF6 gene in myocardium increased after each,compared with the respective gene expression levels before inferior vena cava blockade(P <0.05);but these two in the HTK liquid group The increase in gene expression was significantly lower than that in the blood-containing St.Thomas solution group(P <0.05).After the aorta was opened,the rate of spontaneous rebound in the HTK solution group was higher(P <0.05).There was no difference in the heart index between the two groups of patients before and after the operation(P> 0.05),and there was no difference in the change range of the heart index(P>0.05),but the comparison of the heart index within the group occurred in each group of patients The cardiac index of the postoperative anesthesia state was lower than that of the preoperative anesthesia state(P <0.05).In addition,there was no statistically significant difference in the amount of vasoactive drugs after standardized treatment(P> 0.05).Conclusion In heart valve surgery under cardiopulmonary bypass in adults,both HTK solution and blood-containing St.Thomas solution can provide the myocardial protection effect that meets the surgical requirements,but HTK solution has a better myocardial protection effect than blood-containing St.Thomas solution.In addition,it was confirmed that the expression of C-fos gene and ATF6 gene can be used as the basis for evaluating the protective effect of cardiomyocytes during cardiopulmonary bypass surgery.In addition,it is clear that after undergoing heart valve surgery under cardiopulmonary bypass,the patient's heart function will be damaged in the short term after the operation.