Clinical evaluation of the relative effectiveness of multidose crystalloid and cold blood potassium cardioplegia in coronary artery bypass graft surgery: a nonrandomized matched-pair analysis.
Controversy exists concerning the most effective method of myocardial protection during coronary artery bypass graft operations. Accordingly, we performed a matched-pair analysis between 25 patients receiving multidose hypothermic potassium crystalloid cardioplegia and 25 other patients receiving cold blood potassium cardioplegia. Patients were matched on the basis of preoperative ejection fraction (EF) and the number of anatomically similar stenotic coronary arteries. The adequacy of myocardial protection was assessed by serial perioperative determinations of radionuclide ventriculography, hemodynamic measurements, analyses of electrocardiograms and serum levels of MB-CK. We found that the level of myocardial protection was similar between unstratified groups. However, when subgroups were selected on the basis of prolonged aortic cross-clamp time (greater than ninety minutes) or impaired preoperative left ventricular function (EF less than 40%), there was a suggestion that cold blood cardioplegia may be advantageous.
D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D004796:Clinical Enzyme Tests; D001026:Coronary Artery Bypass; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D006321:Heart / Q000000981:diagnostic imaging; D006324:Heart Arrest, Induced / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D007036:Hypothermia, Induced; D007527:Isoenzymes; D007552:Isotonic Solutions / Q000627:therapeutic use*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000201:enzymology; D011188:Potassium / Q000627:therapeutic use*; D017680:Potassium Compounds; D011877:Radionuclide Imaging; D013318:Stroke Volume
D000889:Anti-Arrhythmia Agents; D007527:Isoenzymes; D007552:Isotonic Solutions; D017680:Potassium Compounds; C018369:potassium cardioplegic solution; D003402:Creatine Kinase; D011188:Potassium