Intermittent antegrade warm blood cardioplegia for CABG: extended interval of cardioplegia.
BACKGROUND
Intermittent delivery of warm cardioplegia provides a bloodless surgical field, but it is clinically important to evaluate the periods of normothermic ischemia. The aims of this study are to compare intermittent antegrade warm blood cardioplegia (IAWBC) with intermittent antegrade cold blood cardioplegia (IACBC) groups in terms of myocardial protection, and also to evaluate whether the length of ischemic time in the IAWBC group has an effect on myocardial dysfunction.


METHODS
This study is based on a retrospective review of patients who underwent elective coronary artery bypass surgery: 162 consecutive patients with IAWBC and 107 consecutive patients with IACBC.


RESULTS
The creatinine kinase peak was smaller in the IAWBC group compared with the IACBC group (p<0.0001). The cardiac index after cardiopulmonary bypass was higher in the IAWBC group (p<0.02), and the amount of inotropic support required to wean from cardiopulmonary bypass was less in the IAWBC group compared with the IACBC group (p<0.0001).


CONCLUSIONS
IAWBC with 30 minutes of ischemia provides to be clinically acceptable myocardial protection for coronary bypass surgery.
Minatoya
K
K
Division of Cardiovascular Surgery, Kokura Memorial Hospital, Fukuoka, Japan. harbour@hsp.ncvc.go.jp
Okabayashi
H
H
Shimada
I
I
Tanabe
A
A
Nishina
T
T
Nandate
K
K
Kunihiro
M
M
D000368:Aged; D001769:Blood; D001831:Body Temperature; D002302:Cardiac Output / Q000502:physiology; D002314:Cardioplegic Solutions / Q000627:therapeutic use*; D002315:Cardiopulmonary Bypass; D002316:Cardiotonic Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D003080:Cold Temperature; D001026:Coronary Artery Bypass; D003402:Creatine Kinase / Q000097:blood; D004280:Dobutamine / Q000627:therapeutic use; D004298:Dopamine / Q000627:therapeutic use; D017558:Elective Surgical Procedures; D006321:Heart / Q000502:physiology; D006324:Heart Arrest, Induced / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors
D002314:Cardioplegic Solutions; D002316:Cardiotonic Agents; D004280:Dobutamine; D003402:Creatine Kinase; D004298:Dopamine