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Response to Letter:

机译：回复信：

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I would like to thank Botta et al, for their letter to the editor and their comments about the case. In response to their questions, I have used this technique in reop-erative cases as well as primary cases. The primary reason it was used in this case was poor left ventricular function. As Dr. Botta mentions, these patients have lower lactate and CCPK-MB levels, which suggests less myocardial injury. I believe that a continuously perfused empty beating heart that is not exposed to ischemia-reperfusion injury is probably the best myocardial protection strategy. My other indications include reoperative cases, and increasingly, I am using it for patients with severe pulmonary hypertension with right ventricular (RV) dysfunction. These patients are susceptible to RV failure if they are operated surgically with cardioplegic arrest. Using this technique and avoiding ischemia-reperfusion injury I have operated on a few "inoperable patients" with excellent results.
机译：我要感谢Botta等人给编辑的信和对此案的评论。为了回答他们的问题，我在手术病例和主要病例中都使用了这种技术。在这种情况下使用它的主要原因是左心室功能不佳。正如Botta博士所提到的，这些患者的乳酸和CCPK-MB水平较低，表明心肌损伤较少。我相信，一个连续灌注的空跳动心脏不暴露于缺血-再灌注损伤可能是最好的心肌保护策略。我的其他适应症包括手术病例，并且越来越多地，我将其用于患有右心室（RV）功能障碍的严重肺动脉高压的患者。如果对这些患者进行心脏停搏手术，则他们很容易出现RV衰竭。使用这种技术并避免了缺血再灌注损伤，我对一些“无法手术的患者”进行了手术，效果极佳。

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