Conduction disturbances after different blood cardioplegia modes in coronary artery bypass grafting. Including comparison with an earlier patient series.
One-hundred and nine patients undergoing coronary artery bypass grafting were randomized to seven groups according to cardioplegia technique (5 types) and right coronary patho-anatomy (2 types). There were no major intergroup differences in postoperative outcome. Conduction disturbances developed in 26 patients, also without intergroup difference. Factors predictive of conduction disturbances were studied by univariate and multivariate analyses. Patients with such disturbances had lower myocardial temperatures than the others and more often postoperative atrial fibrillation (10/26 vs 15/83, p < 0.05). Comparison of this case series with a prospective study from our hospital in 1988-1989 showed that myocardial protection was superior in the present study. The incidence of right bundle branch block was similar in the two studies (24% vs 23%), but that of left-side conduction disturbances (bundle branch or fascicular block) was dramatically reduced (19% vs 1%, p < 0.0001) concomitantly with improved myocardial protection, indicating that development of a left-side conduction disturbance is associated with myocardial injury.
Pehkonen
E J
EJ
Department of Thoracic and Cardiovascular Surgery, Tampere University Hospital, Finland.
Honkonen
E L
EL
Mäkynen
P J
PJ
Kataja
M J
MJ
Tarkka
M R
MR
D001145:Arrhythmias, Cardiac / Q000209:etiology*; D002037:Bundle-Branch Block / Q000209:etiology; D001026:Coronary Artery Bypass; D005260:Female; D006324:Heart Arrest, Induced / Q000379:methods*; D006329:Heart Conduction System; D006801:Humans; D008297:Male; D008875:Middle Aged