Baranovskiy M. Comparative evaluation of myocardial protection methods on the basis of crystalloid cardioplegic solutions in congenital heart diseases surgery

The thesis is dedicated to the myocardial protection by crystalloid solutions used during the principal stage of congenital heart diseases surgery. On the basis of 291 patients examination, short-term results have been analyzed and the effectiveness of different cardioplegic solutions and methods of myocardial protection including duration of ischemia have been compared. The author has determined the drawbacks and limitations of the techniques mentioned. The new approach on myocardium reperfusion injury prevention after circulation renewal was designed and implemented . It prevents "calcium paradox" and hyperoxic injury of myocardiocites. The techniques of existing cardioplegic solutions routinely used in congenital heart diseases therapy were modified. Designed techniques of crystalloid oxygen-containing cardioplegic solutions with low level calcium, and modified techniques of reperfusion myocardial injury prevention enabled the decrease of postoperative heart failure level under a long-term aorta cross-clamping from 86% to 67%.