title: Blood cardioplegia with warm reperfusion versus intermittent aortic crossclamping in myocardial revascularization. Randomized controlled trial.
abstract: To compare the efficiency of two methods of myocardial protection--blood cardioplegia and warm reperfusion with aspartate-glutamate enrichment of the solution versus intermittent aortic crossclamping--we randomized 60 patients for coronary artery bypass grafting. Hemodynamic parameters and hospital mortality were the end points. Pathologic antecedents and preoperative clinical conditions were similar in both group I (blood cardioplegia, 30 patients) and group II (aortic crossclamping, 30 patients). An average of 2.9 grafts per patient were performed in group I and 3.1 in group II. Duration of extracorporeal circulation was 100 +/- 28 minutes in group I and 85 +/- 23 minutes in group II (p < 0.05). The total time of aortic crossclamping was 62.8 +/- 24.5 minutes in group I and 44.3 +/- 14.9 minutes in group II (p < 0.05). There were comparable increases in cardiac index in group I and group II from the preoperative period to the first postoperative day, but none of these changes reached statistical significance. There were two deaths, one in the cardioplegia group (3.3%) and another in the intermittent aortic crossclamping group (3.3%). In conclusion, in myocardial revascularization, intermittent aortic crossclamping and blood cardioplegia with warm reperfusion enriched with aspartate-glutamate solution are methods of similar efficiency.
authors.affiliation: Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo, Brazil.
authors.forename: L R
authors.initials: LR
authors.lastname: Gerola
authors.forename: S A
authors.initials: SA
authors.lastname: Oliveira
authors.forename: L F
authors.initials: LF
authors.lastname: Moreira
authors.forename: L A
authors.initials: LA
authors.lastname: Dallan
authors.forename: P
authors.initials: P
authors.lastname: Delgado
authors.forename: P L
authors.initials: PL
authors.lastname: da Luz
authors.forename: A D
authors.initials: AD
authors.lastname: Jatene
mesh_terms: D001011:Aorta; D001224:Aspartic Acid; D001769:Blood; D002314:Cardioplegic Solutions; D003250:Constriction; D001026:Coronary Artery Bypass; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D005971:Glutamates; D018698:Glutamic Acid; D006324:Heart Arrest, Induced / Q000379:methods; D006439:Hemodynamics; D006801:Humans; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D015425:Myocardial Reperfusion / Q000379:methods; D011183:Postoperative Complications; D013696:Temperature
chemical_list: D002314:Cardioplegic Solutions; D005971:Glutamates; D007527:Isoenzymes; D001224:Aspartic Acid; D018698:Glutamic Acid; D003402:Creatine Kinase