作者：姜相伟，张载高，贝亚军，解水本，贾群，薛志强，赵哲， 李寒

【摘要】  目的总结3例较长时间供心缺血［367～542（465）min］的原位心脏移植体外循环管理经验。方法1例二次手术者采用股动脉、股静脉及上腔静脉插管，另2例采用升主动脉及上、下腔静脉插管；采用中度低温（鼻咽温28.1℃～29℃），轻-中度血液稀释（血红蛋白 82～119 g/L），50～83 ml/(kg·min)的流量进行体外循环灌注；供心保护方法：经主动脉根部灌注冷心脏停搏液，快速取下心脏，再灌注冷UW液，并放置于UW液中低温保存。结果3例均顺利脱离体外循环机，术后康复出院。结论合理的灌注技术及良好的心肌保护，可使供心冷保存时间较长的原位心脏移植获得成功。

【关键词】  心脏延时保存；体外循环；心脏移植

　　The Management of Extracorporeal Circulation in Heart Transplantation With Long-time Preserved Heart

　　Abstract: OBJECTIVE To summarize the clinical experience of extracorporeal circulation in 3 cases of heart transplantation with long-time preserved heart (6h and 7m-9h 2m, mean 7h45m). METHODS One case was performed the second operation with cannulation of fermoral artery, fermoral vein and superior vena eava. The other two cases were performed with fermoral artery, ascending aorta and two-stage cannulation. All 3cases were given moderate hypothermic(from 28.1℃ to 29℃), light- moderate blood dilution(Hb from 82 to 119g/L), and perfusion flow from 50 to 83ml/(kg·min). Heart preservation: The donor heart was arrested with aorta perfusion the cold cardioplegic solution, after being har……