The levels of markers of the myocardium damage and state of the oxygen budget in patients, suffering the mitral valve insufficiency in surgical correction, using crystalloid cardioplegia

Abstract

Objective. Аnalysis of levels of the myocardium damage markers and state of the oxygen budget in patients, suffering the mitral valve insufficiency, in surgical correction, using crystalloid cardioplegia, was performed. Маterials and methods. There were examined 40 patients, suffering the mitral valve insufficiency and ageing (56.2 ± 4.5) yrs old, admitted to the Institute of the Heart MH of Ukraine for surgical correction of the failure. The therapy and operative intervention, the mitral valve prosthesis, were conducted in the patients in accordance to actual local protocol of intraoperative cardioprotection, using the crystalloid cardioplegia (Bretschtider’s solution). The markers levels, concerning the myocardium affection (troponin I, sodiumuretic peptide, alaninaminotranspherase, aspartataminotransphefase, creatinphosphokinase, МВ fraction of creatinephosphokinase), indices of the oxygen budget (hemoglobin, hematocrit, hemoglobin saturation by oxygen in arterial and venous blood, partial pressure of oxygen in arterial and venous blood, lactate) were performed in the patients while exit from perfusion, before admittance to the Department of Intensive Therapy and discharge from it. There were calculated: the ratio of creatinephosphokinase-MB towards creatinephosphokinase, аrterio-venous difference of hemoglobin saturation by the oxygen, content of oxygen in arterial and venous blood, transport, consumption of oxygen and coefficient of the oxygen extraction by the tissues. Results. The levels of markers investigated, concerning affection of myocardium in the patients, did not exceeded the norm range, while statistically significant dynamics was registered only for concentration of sodiumuretic peptide and ratio of creatinephosphokinase-MB towards creatinephosphokinase. The indices of hemic chain of the oxygen transport trustworthily lowered while exit from perfusion only. Тhe oxygen transport and consumption after the failure correction have reduced trustworthily, while coefficient of the oxygen extraction by the tissues did not change essentially. Arterio-venous difference for the oxygen content have reduced trustworthily, but on this background the lactate level have raised significantly. Conclusion. The levels of markers studied, concerning the myocardium damage, did not differ during the investigation course essentially, what witnesses satisfactory state of myocardium.

Keywords

• markers of the myocardium damage; the oxygen budget; the mitral valve insufficiency; artificial blood circulation; crystalloid cardioplegia.