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Interrupted warm blood cardioplegia for coronary artery bypass grafting.
- Source :
-
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery [Eur J Cardiothorac Surg] 1995; Vol. 9 (3), pp. 133-8. - Publication Year :
- 1995
-
Abstract
- Continuous warm blood cardioplegia has been used with good clinical outcome in both antegrade and retrograde delivery. However, the continuous delivery of cardioplegia is sometimes interrupted for adequate visualization and flow is not constant with heart manipulation during operation. We studied the effects of interrupted antegrade delivery of warm blood cardioplegia on myocardial metabolism and clinical results after surgery. Fifty-five patients undergoing isolated coronary bypass surgery received warm blood cardioplegia (n = 29) or cold crystalloid cardioplegia (n = 26) in an antegrade fashion. During reperfusion, myocardial oxygen consumption, lactate extraction, creatinine kinase isoenzyme (CK-MB), and malondialdehyde (MDA) were measured. Post-operatively, serum CK-MB and cardiac output (CO) were determined over a period of time. Myocardial oxygen extraction in the warm group was significantly greater than in the cold group 1 min after reperfusion (P < 0.02). The results revealed a tendency for patients in the warm group to have prior lactate extraction, although the difference did not reach statistic difference (P < 0.10). After removal of the aortic cross-clamp, the heart returned to sinus rhythm spontaneously in 90% of the patients with warm cardioplegia and 15.4% of those with a cold heart (P < 0.01). Postoperatively, there was no significant CK-MB or MDA release in either group except for one patient with perioperative myocardial infarction. After operation inotropic support was required for two and one patient in the warm and cold groups, respectively, although there were significantly more patients with poor left ventricular function in the warm, than in the cold, group (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
- Subjects :
- Adult
Aged
Cardiac Output physiology
Creatine Kinase blood
Female
Humans
Hypothermia, Induced methods
Isoenzymes
Lactates blood
Lactic Acid
Male
Malondialdehyde blood
Middle Aged
Myocardial Reperfusion Injury diagnosis
Myocardial Reperfusion Injury mortality
Oxygen Consumption physiology
Postoperative Complications mortality
Postoperative Complications physiopathology
Survival Rate
Temperature
Coronary Artery Bypass methods
Energy Metabolism physiology
Heart Arrest, Induced methods
Myocardial Reperfusion Injury physiopathology
Myocardium metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 1010-7940
- Volume :
- 9
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 7786529
- Full Text :
- https://doi.org/10.1016/s1010-7940(05)80059-4