[Effectiveness of retrograde tepid blood cardioplegia in valve surgery combined with coronary artery bypass grafting].
The purpose of this study was to evaluate the usefulness of continuous retrograde continuous tepid blood cardioplegia (CTBC) in 8 patients underwent multivalve surgery combined with coronary artery bypass grafting (CABG) (Group 1), in comparison with antegrade CTBC in 10 patients with single valve replacement (Group 2). Aortic crossclamp time in Group 1 (187.9 +/- 55.2 minutes) was significantly longer than that (94.1 +/- 27.4) in Group 2 (p < 0.005). There was no hospital death in both groups. Spontaneous recovery rate of the heart beat following aortic declamping was 75% in Group 1, 90% in Group 2 (ns). Postoperative max CK-MB was 87.9 +/- 43.1 IU/l in Group 1, 74.8 +/- 27.0 IU/l in Group 2 (ns). During the early postoperative period, LVSWI significantly increased in both groups, whereas RVSWI showed no significant increase in both groups. Accordingly, in Group 1 in spite of longer aortic crossclamp time comparing Group 2, myocardial protection was considered to be satisfactory. In conclusion, retrograde CTBC is useful as an intraoperative myocardial protection in multivalve surgery combined with CABG which must need much longer aortic cross clamp time.
Department of Cardiovascular Surgery, Tsuchiura Kyodo General Hospital, Japan.
H
H
Nagaoka
M
M
Ohnuki
K
K
Hirooka
T
T
Shimoyama
D000368:Aged; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications / Q000601:surgery; D005260:Female; D006324:Heart Arrest, Induced / Q000379:methods*; D006334:Heart Function Tests; D006349:Heart Valve Diseases / Q000150:complications / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies