Coronary sinus versus aortic root perfusion with blood cardioplegia in elective myocardial revascularization.
The role of retrograde coronary sinus cardioplegia in patients undergoing elective coronary artery bypass grafting has not been fully defined. Forty patients undergoing coronary artery bypass grafting received either aortic root (20 patients) or coronary sinus (20 patients) cold potassium blood cardioplegia. The patients were similar with respect to age, ventricular function, severity of coronary artery disease, cross-clamp time, completeness of revascularization, frequency of internal mammary artery grafting, and mean infusate volume and temperature. The time required to deliver the initial dose of cardioplegic solution and the time to achieve arrest were prolonged in the coronary sinus group (p less than 0.001 and p less than 0.02, respectively). There were no differences between the two groups postoperatively with regard to enzymatic indices, hemodynamic measurement, or clinical outcome. Right ventricular function was preserved equally in both groups. We conclude that coronary sinus cardioplegia is a safe alternative to aortic root perfusion, but offers no advantage in elective myocardial revascularization.
Fiore
A C
AC
Department of Surgery, St. Louis University Medical Center, MO 63110-0250.
Naunheim
K S
KS
Kaiser
G C
GC
Willman
V L
VL
McBride
L R
LR
Pennington
D G
DG
Barner
H B
HB
D000368:Aged; D001011:Aorta; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000628:therapy; D001026:Coronary Artery Bypass; D003331:Coronary Vessels; D003402:Creatine Kinase / Q000097:blood; D004554:Electric Countershock; D005260:Female; D006324:Heart Arrest, Induced / Q000379:methods*; D006801:Humans; D007527:Isoenzymes; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D011183:Postoperative Complications; D013318:Stroke Volume
D007527:Isoenzymes; D007770:L-Lactate Dehydrogenase; D003402:Creatine Kinase