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This journal is published by the University Library System of the University of Pittsburgh as part  

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Heart and Lungs Protection 

Technique for Cardiac Surgery 

with Cardiopulmonary Bypass 

 

Vladimir Pichugin1, Nikolay 

Melnikov2, Farkhad Olzhayev3, 

Alexander Medvedev1, Sergey 

Jourko2, Alishir Gamzaev2, 

Vladimir Chiginev2 

 
1Nizhny Novgorod State Medical 
Academy, Russia; 2Cardiac and Vascular 
Surgery Centre, Nizhny Novgorod, 
Russia; 3Center for Life Sciences, 
Nazarbayev University, Astana, 
Kazakhstan  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vol. 3, Suppl. (2014)   |   ISSN 2166-7403 (online)    

DOI 10.5195/cajgh.2014.169   |   http://cajgh.pitt.edu 

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PICHUGIN 

 

 

This work is licensed under a Creative Commons Attribution 4.0 United States License. 

 

This journal is published by the University Library System of the University of Pittsburgh as part  

of its D-Scribe Digital Publishing Program and is cosponsored by the University of Pittsburgh Press. 

 

Central Asian Journal of Global Health 

Volume 3, Suppl. (2014)  |  ISSN 2166-7403 (online)  |  DOI 10.5195/cajgh.2014.169  |  http://cajgh.pitt.edu 

  

 

Abstract 

Introduction: Cardioplegic cardiac arrest with subsequent ischemic-reperfusion injuries can lead to the development of 

inflammation of the myocardium, leucocyte activation, and release of cardiac enzymes. Flow reduction to the bronchial arteries, 

causing low-flow lung ischemia, leads to the development of a pulmonary regional inflammatory response. Hypoventilation during 

cardiopulmonary bypass (CPB) is responsible for development of microatelectasis, hydrostatic pulmonary edema, poor compliance, 

and a higher incidence of infection. Based on these facts, prevention methods of these complications were developed. The aim of 

this study was to evaluate constant coronary perfusion (CCP) and the “beating heart” in combination with pulmonary artery 

perfusion (PAP) and “ventilated lungs” technique for heart and lung protection in cardiac surgery with CPB. 

Methods. After ethical approval and written informed consent, 80 patients undergoing cardiac surgery with normothermic CPB 

were randomized in three groups. In the first group (22 patients), the crystalloid cardioplegia without lung ventilation/perfusion 

techniques were used. In the second group (30 patients), the CCP and “beating heart” without lung ventilation/perfusion techniques 

were used. In the third group (28 patients), the CCP with PAP and lung ventilation techniques were used. Clinical, functional 

parameters, myocardial damage markers (CK MB level), oxygenation index, and lung compliance were investigated. 

Results. There were higher rates of spontaneous cardiac recovery and lower doses of inotrops in the second and third groups. 

Myocardial contractility function was better preserved in the second and third groups. The post-operative levels of CK-MB were 

lower than in control group.  Three hours after surgery CK-MB levels in the second and third  groups were lower by 38.1% and 

33.3%, respectively. Eight hours after surgery, CK-MB levels were lower in the second and third groups by 45.9% and  47.7%, 

respectively. 24 hours after surgery, CK-MB levels were lower in the second and third groups by 42.0% and  42.6%, respectively, 

and lower by 29.7% and 27.4% 48 hours after surgery, respectively. Normalization of CK-MB levels were registered earlier in 

second and third groups (within 24 hours) than the control group. Oxygenation index and lung compliance were significantly higher 

in the third group after CPB. 

Conclusion. Our technique improved myocardial and lung function in patients, but larger prospective randomized trials are needed 

to definitively assess the protective effects of this technique. 

Keywords: constant coronary perfusion, pulmonary artery perfusion, cardiopulmonary bypass 

 

 

 

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