高频电切针透壁打孔对犬缺血心肌血管重建.docVIP

高频电切针透壁打孔对犬缺血心肌血管重建 　 作者：戴炳光，徐巨林，蔡茗叶，曲崎，张经国，张峰，芦昌慧，杨岷 【关键词】 心肌血管重建术 Transmyocardial revascularization in dogs with acute myocardial ischemia by an alto frequency needle of electrosurgical generator 　　　　【Abstract】 AIM: To investigate myocardial revascularization and pathological changes following myocardial acupuncture with a domestic alto frequency needle of electrosurgical generator in dogs with acute myocardial ischemia. METHODS：After an area of acute myocardial ischemia was established, 30 dogs were randomly divided into 3 groups. Of them, 10 dogs served as control group(Group A)in which no specific treatment was committed after ligation of the second branch of LAD; in another 10 dogs(Group B)，needle puncture was used; the rest 10 dogs served as electrosurgical needle group (Group C) in which the myocardium of the ischemic area was drilled with a domestic monopolar needle connected to a Valleylab Force 2 electrosurgical generator with pure cut energy at 120-160 W. The needle diameter (1 mm) and transmural channel density(1 cm) applied in Group B and Group C were the same except no connection to an electrosurgical generator in Group B. Dog hearts were harvested at intervals of l d，1，2，4，and 8 weeks after surgery．The contents of microvessel and fibrosis were evaluated with a light microscope and the mitochondria changes were studied with an electron microscope. RESULTS: Two dogs in Group A died 7 and 23 h after operation，respectively．One died of bacillary dysentery, the other due to an unknown cause．Three dogs in Group C developed ventricular tachycardia which lasted 20-120 seconds． No mitral valve damages and thrombosis in the chamber of left ventricle were found． Microscopic channels existed in Group C 2 weeks after operation，but not in group B(seen only at 1 week postoperatively)．Channels were blocked by granulation tissue and scar tissue 2-8 weeks after operation．Thermal injure was obvious around the channels made by pure cut of electrosurgical generator． Four