The study examined effectiveness of pharmaco-cold cardioplegia employing solutions of enhanced buffer capacity during surgery of obstructive hypertrophic cardiomyopathy in adult patients (N=51) operated during 2013-2018. In group 1 (N=28), the cardioplegia was performed with HTK (Custodiol) solution, whereas in group 2 (N=23), it was carried out with Bokeria—Boldyrev ACH solution. The mean, minimum, and maximum ages in group 1 were 46, 21, and 64 years, respectively; in group 2 — 42, 14, and 70 years, respectively. In both groups, the patients were subjected to myoectomy of exit pathway in the left ventricle according to Bokeria—Morrow operation and annuloplasty of tricuspid valve accompanied by reconstructive surgery (or replacement) of mitral valve. Atrial fibrillation (if any) was suppressed with cryoablation (-60°С) of the openings of the right and left pulmonary veins. The surgery was carried out in hypothermic mode at 28°C. The significant intergroup differences were observed in the asystole latent period after the onset of antegrade or retrograde injection of cardioplegic solution. In group 1, the asystole latent periods determined after antegrade or retrograde injection were 53±7 or 170±30 sec, respectively; in group 2 — 32±6 and 97±11 sec (p<0.0001), respectively. The mean times of aortic cross-clumping in groups 1 and 2 were 66±8 and 64±6 min, respectively; the electromechanical action of the heart restored after aortic unclamping in 35±7 and 30±6 sec, respectively. The biochemical and clinical data revealed no significant intergroup differences. Overall, novel Bokeria—Boldyrev ACH cardioplegic solution secured effective protection of the myocardium against intraoperative ischemia in adult patients with obstructive hypertrophic cardiomyopathy and significantly decreased the asystole latent period.

中文翻译：

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Bokeria-Boldyrev ACH 溶液在成人阻塞性肥厚型心肌病手术治疗中的有效性

该研究检查了在 2013 年至 2018 年期间接受手术的成年患者（N=51）阻塞性肥厚性心肌病手术期间采用增强缓冲能力溶液的药物冷心停搏液的有效性。在第 1 组（N=28）中，使用 HTK（Custodiol）溶液进行心脏停搏，而在第 2 组（N=23）中，使用 Bokeria-Boldyrev ACH 溶液进行心脏停搏。第 1 组的平均、最小和最大年龄分别为 46、21 和 64 岁；第 2 组——分别为 42、14 和 70 岁。两组患者均按照Bokeria-Morrow手术及三尖瓣瓣环成形术联合二尖瓣重建术（或置换术）行左心室出口通路肌切除术。右肺和左肺静脉开口冷冻消融 (-60°С) 抑制了房颤（如果有）。手术在28°C的低温模式下进行。在心脏停搏液顺行或逆行注射开始后的心搏停止潜伏期观察到显着的组间差异。在第1组中，顺行或逆行注射后测定的心搏停止潜伏期分别为53±7或170±30秒；在第 2 组中 — 分别为 32±6 和 97±11 秒（p<0.0001）。第1组和第2组主动脉交叉结块的平均时间分别为66±8和64±6分钟；分别在 35±7 和 30±6 秒内松开主动脉后心脏的机电活动恢复。生化和临床数据显示没有显着的组间差异。全面的，