网膜心脏固定术增加缺血心肌激光再血管化的远期疗效

Experimental Study of Cardio-omentopexy with Transmyocar-dial Laser Revascularization Enhance the Long-term Efficacy on Ischemic Area

心肌Nd:YAG激光孔道远期均为纤维组织闭塞,采用网膜心脏固定术增加对缺血心肌远期的保护作用。18条杂交犬分为3组:对照组(n=6)、激光心肌再血管化组(n=6)和激光心肌再血管化+网膜心脏固定术组(n=6)。对照组仅结扎左侧冠状动脉前降支的对角支、中间支的第一、二支,及与之相连的左侧回旋支的钝缘支的吻合支,建立动物模型。单纯激光心肌再血管化组:用Nd:YAG激光刀,于左室壁心肌缺血区直接贯穿打孔6～8个,孔间距10mm。网膜心脏固定术组在激光心肌再血管化后,行大网膜经皮下遂道移植于心脏表面。术后4周行放射性同位素^(86)Rb摄取分数,示踪剂检查和心肌组织学活捡。结果显示网膜心脏固定术缺血心肌区远期的放射性同位素^(86)Rb摄取分数增加,网膜—心肌测支血液循环建立。

The transmyocardial Nd:YAG laser channels would become fibrosis,cardio-omen-topexy were used to enhanse the long-term efficacy in salvaging myocardial ischemia on canine heart models. Eighteen normal mongrel dogs were divided into three groups: control group (n = 6), transmyocardial laser revascularization group (TLP,n = 6)and cardio-omentopexy with TLR group(n = 6). Nd :YAG laser was used to create 6-8 transmyocardial channels 10mm apart from each other in the ischemic area of anterior wall of ventricle in 12 dogs of the last two groups Six dogs of them pedicled omental graft were immediately operated. After 4 weeks, fractional Kb uptake, the examination of injecting indian ink into coeliac artery and biopsy were obtained. Our results revealed that the cardio-omentopeexy procedure can increase fractional Rb uptake of the ischemic myocardium, and there were collateral circulation between the omentum and the myocardium.