[Cardioplegic arrest and intermittent aortic clamping: comparison in coronary artery bypass graft].
427 randomized patients undergoing coronary artery bypass graft (CABG) were divided into two groups. In Group A (269 patients), myocardial protection was achieved using cardioplegic solution (Bretschneider). Group B (158 patients) was operated with intermittent aortic cross-clamping. Between both groups there was no significant difference in early postoperative mortality rates, incidence of postoperative low output syndrome, perioperative myocardial infarctions, length of ICU-stay, length of intubation, incidence of arrhythmia, and inotropic requirements. The ratio of reperfusion time divided by aortic cross-clamping time (R/C-ratio) in Group B (1.06 + 1.17) was larger than in Group A (0.49 + 0.17), which could explain this result. In Group A significantly larger incidence of postoperative arrhythmia was recognized, if reperfusion time was shorter than 20 minutes. Also in Group A, longer postoperative intubation was required with R/C-ratio under 0.60. In Group B longer intubation was needed postoperatively with aortic cross-clamping time longer than 30 minutes, reperfusion time shorter than 30 minutes, or R/C-ratio under 0.80. In conclusion, reperfusion should be continued at least for 20 minutes and if possible, for the length equivalent to R/C-ratio over 0.60 in CABG with presently widely used cardioplegic arrest.
Saitoh
H
H
Deutsches Herzzentrum München, Klink für Herz- und Gefässchirurgie.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic; D002314:Cardioplegic Solutions; D003250:Constriction; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*
D002314:Cardioplegic Solutions