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Initial experience with low-potassium cold blood cardioplegia: a clinical comparative study.
Initial experience with low-potassium cold blood cardioplegia: a clinical comparative study.
- Source :
-
The Annals of thoracic surgery [Ann Thorac Surg] 1992 Apr; Vol. 53 (4), pp. 628-34. - Publication Year :
- 1992
-
Abstract
- This study presents the results of bypass grafting in 96 patients operated on for triple-vessel coronary artery disease between May 1988 and September 1990. In the first 54 patients a cold crystalloid solution was employed, and in the 42 more recent patients cold blood low-potassium cardioplegia was employed. There were no differences in postoperative cardiac index or left ventricular stroke work index. Yet, in patients with impaired prebypass left ventricular stroke work index, postbypass left ventricular performance correlated negatively with duration of aortic cross-clamping in the cold crystalloid group (r = -0.441, p = 0.045). In contrast, no correlation was found in the cold blood low-potassium group (r = 0.125, p = 0.587). The incidence of myocardial infarction, need for inotropic support, and need for intraaortic balloon counterpulsation were similar among the groups. Release of the myocardial isoenzyme creatine kinase-MB from 12 to 30 hours after operation was significantly less in the low-potassium blood cardioplegia group. The use of low-potassium blood cardioplegia resulted in a marked reduction in the operative administration of fluids (1,527 +/- 87 versus 3,511 +/- 148 mL; p less than 0.001). In conclusion, low-potassium cold blood cardioplegia is a simple and effective method of myocardial protection. The fact that left ventricular stroke work index recovery was not dependent on the duration of aortic occlusion and that release of the MB isoenzyme of creatine kinase was reduced in the low-potassium blood cardioplegia group implies better myocardial protection.
- Subjects :
- Adult
Aged
Aged, 80 and over
Arrhythmias, Cardiac etiology
Cardioplegic Solutions administration & dosage
Cardioplegic Solutions analysis
Coronary Circulation physiology
Coronary Disease surgery
Counterpulsation
Creatine Kinase blood
Female
Humans
Hypertonic Solutions
Isoenzymes
Male
Middle Aged
Myocardial Contraction physiology
Potassium administration & dosage
Potassium analysis
Stroke Volume physiology
Treatment Outcome
Vascular Resistance physiology
Ventricular Function, Left physiology
Ventricular Function, Right physiology
Blood
Cardioplegic Solutions therapeutic use
Heart Arrest, Induced methods
Potassium therapeutic use
Potassium Compounds
Subjects
Details
- Language :
- English
- ISSN :
- 0003-4975
- Volume :
- 53
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The Annals of thoracic surgery
- Publication Type :
- Academic Journal
- Accession number :
- 1554272
- Full Text :
- https://doi.org/10.1016/0003-4975(92)90323-v