[Effect of different types of pharmacocryocardioplegia on the occurrence of cardiac rhythm and conduction disturbances in the early postoperative period in patients with ischemic heart disease].
109 patients who underwent operation for formation of an aortocoronary shunt (ACS) were divided into 3 groups according to the method of introducing a cardioplegic solution and reperfusion. Thirty-five patients (group 1) underwent antegrade cardioplegia and direct reperfusion. Thirty-seven (group 2) were subjected to mixed antegrade-retrograde cardioplegia. Group 3 consisted of 37 patients with myocardial protection accomplished by the same method as in group 2, but retrograde perfusion was with warmed oxygenated blood through the right atrium was conducted before removing the clamp from the aorta. The effect of various types of pharmacocryocardioplegia on the appearance of new disorders of rhythm and conductivity in the early postoperative period after ACS formation was analysed. The frequency of sinus tachycardia was less in group 3 (24%) than in groups 1 and 2 (51 and 51%, respectively, p less than 0.05). We obtained no statistically significant differences in the frequency of other types of arrhythmias in these 3 groups. However, the number of transient bundle-branch blocks and disorders of intraventricular conductivity (8.1 and 10.8%, respectively) in group 3 was also less than that in groups 1 and 2 (p less than 0.05) and their regression was faster. We believe that combined anterograde-retrograde cardioplegia applied together with retrograde reperfusion with warmed oxygenated blood is most effective not only in protection of the conduction system of the heart but also in protection of the right- and left-ventricular myocardium.
Bokeria
L A
LA
Kertsman
V P
VP
Poplavskaia
L M
LM
Bobrakov
O V
OV
Karelidis
I K
IK
D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000601:surgery*; D002314:Cardioplegic Solutions / Q000008:administration & dosage; D003131:Combined Modality Therapy; D006324:Heart Arrest, Induced / Q000379:methods*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000601:surgery; D015425:Myocardial Reperfusion; D011183:Postoperative Complications / Q000601:surgery*; D013610:Tachycardia / Q000209:etiology / Q000601:surgery*; D013997:Time Factors
D002314:Cardioplegic Solutions