[Comparative study of cardioplegia and intermittent cross-clamping in myocardial revascularization surgery].
OBJECTIVE
To compare the effects of two methods for myocardial preservation during coronary artery by pass graft (CABG): the intermittent aortic cross-clamping (IACC) and the cold hyperkalemic solution (CHS).


METHODS
One hundred and sixty-three patients operated for CABG between October/83 to May/84 were studied retrospectively. Those operated in emergency situations, reoperations and those who required concomitant additional procedures were excluded. The surgical technique used in both groups was essentially the same. Group I comprised 93 cases (40-70 years-old, median 57.7% y; 86% male) in which IACC were used. Group II comprised 70 cases (37-72 years old, median 67.7 y; 80% male) in which CHS (St. Thomas) was injected into the aortic root. The patients were evaluated in the immediate postoperative period at 3, 6, 12 months and then in variable periods until the 61 months of late follow-up. Myocardial ischemia and infarction, the use of drugs and the hospital time recovery were evaluated. The occurrence of symptoms, return to work, physical capacity, reinternations, reoperations and late deaths were evaluated in the late follow-up.


RESULTS
During hospital period, no death was observed. Perioperative myocardial infarct was similar in both groups (group I = 2.1% and group II = 1.4%) statistical difference in the others parameters was observed. Of 95.5% of the patients who had postoperative observations, 80% had a late follow-up ranged from 30 to 61 months (median 38 months). One patient of each group had a cardiac death. In both groups (group I--1 patient and group II--4 patients) coronary insufficiency symptoms related were present and no statistical difference in the others parameters was observed.


CONCLUSIONS
CHS or IACC were efficient and similar methods for myocardial protection in an elective group of patients submitted to a CABG in the immediate and late follow-up.
Jatene
F B
FB
Instituto do Coraçăo do Hospital das Clínicas, FMUSP.
Ferreira
H P
HP
Ramires
J A
JA
Oliveira e Silva
M
M
Fróes
L B
LB
Siaulys
M
M
de Oliveira
S A
SA
Jatene
A D
AD
D000328:Adult; D000368:Aged; D001011:Aorta / Q000601:surgery*; D003250:Constriction; D001026:Coronary Artery Bypass / Q000379:methods*; D005112:Extracorporeal Circulation; D005260:Female; D005500:Follow-Up Studies; D006324:Heart Arrest, Induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications
Estudo comparativo da cardioplegia e do clampeamento intermitente em cirurgia de revascularização do miocárdio.