METHOD FOR MYOCARDIUM PROTECTION AGAINST REPERFUSION INJURIES IN HEART OPERATIONS (EMBODIMENTS) Russian patent published in 2020 - IPC A61B17/00 A61M1/02 

FIELD: medicine.

SUBSTANCE: invention relates to surgery, in particular to cardiosurgery. Before heart cavity opening, carbon dioxide gas is fed through rotameter into cavity of opened pericardium with pressure of 0.2–0.4 MPa and volume rate of 2-3 l/min. Carbon dioxide is supplied during the whole main stage of operation, and stops after sealing of heart cavities and removal of clamp from aorta. Second embodiment of the invention involves: prior to removal of a clamp from the aorta, retrograde thermal blood perfusion is performed with an IC apparatus with addition of magnesium at rate of 200 ml/min for 2 minutes. In the perfusate of the IC apparatus, the following parameters should be achieved by this time: hematocrit - 25–30 %, Ca²⁺ - 1.2–1.3 mmol/l, K⁺ - 4.5–5.5 mmol/l, Hb - 90–100 g/l, glucose - norm, BE: + 2–3. After removal of a clamp from the aorta, complete IC with left ventricular unloading was continued. Duration of reperfusion depends on aortic clamping time and ranges from 15 to 25 minutes. Count is started after removing the clamp from the aorta and continued for not less than 10 minutes from the moment of restoration of the regular rhythm or the beginning of the temporary cardiac pacing. During this period cardiac preparations were not introduced. Reperfusion completion criteria are stable rhythm normalization, return of the ECG complex to the preoperative pattern, as well as adequate myocardial response to the volume load.

EFFECT: method enables reducing the frequency of use, dosage and the number of antiarrhythmic and inotropic preparations when disconnected from artificial blood circulation, minimizing the effect of damaging factors on the myocardium in the first minutes after the period of global ischemia, in order to prevent and restore the function of reversibly depressed cardiomyocytes.

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