Comparison of single versus multidose blood cardioplegia in arterial switch procedures.
Fifty-three patients with transposition of the great arteries and Taussig-Bing anomaly undergoing an arterial switch procedure were divided into two groups. Group 1 (N = 32) received multidose cardioplegia injected initially into the aortic root and subsequently into the coronary artery orifices and Group 2 (N = 21), single-dose cardioplegia injected into the aortic root. The mean aortic cross-clamp and bypass times were generally longer in Group 1 compared with Group 2. Group 1 patients with simple transposition undergoing primary repair (N = 15) had an aortic cross-clamp time of 80 +/- 8 minutes and a bypass time of 203 +/- 27 minutes versus 64 +/- 6 minutes (p less than 0.001) and 170 +/- 15 minutes (p less than 0.01), respectively, for similar patients in Group 2 (N = 10). Group 1 patients with simple transposition undergoing staged repair (N = 7) had an aortic cross-clamp time of 71 +/- 6 minutes and a bypass time of 201 +/- 24 minutes versus 66 +/- 4 minutes (p = not significant [NS]) and 226 +/- 25 minutes (p = NS), respectively, for Group 2 (N = 6). In Group 1 patients with complex transposition (N = 10), the aortic bypass time was 79 +/- 12 minutes and the bypass time was 261 +/- 40 minutes versus 64 +/- 11 minutes (p less than 0.05) and 225 +/- 16 minutes (p less than 0.1), respectively, for Group 2 (N = 5). Early mortality was 16% (5/32) in Group 1; there were no early deaths in Group 2.(ABSTRACT TRUNCATED AT 250 WORDS)
DeLeon
S Y
SY
Division of Cardiovascular-Thoracic Surgery, Children's Memorial Hospital, Chicago, IL 60614.
Idriss
F S
FS
Ilbawi
M N
MN
Duffy
C E
CE
Benson
D W
DW
Backer
C L
CL
D001011:Aorta; D002314:Cardioplegic Solutions / Q000008:administration & dosage*; D002675:Child, Preschool; D003250:Constriction; D004452:Echocardiography; D004562:Electrocardiography; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007269:Injections, Intra-Arterial; D011183:Postoperative Complications / Q000401:mortality; D013997:Time Factors; D014188:Transposition of Great Vessels / Q000503:physiopathology / Q000601:surgery*
D002314:Cardioplegic Solutions