title: Comparison between warm blood and crystalloid cardioplegia during open heart surgery.
abstract: OBJECTIVE
  This study was designed to compare the degree of myocardial protection afforded by warm blood and cold crystalloid cardioplegia in a group of patients undergoing elective coronary artery bypass surgery.
  
  
  METHODS
  Seventeen patients, were randomly assigned to Group A (n=9), who received crystalloid cardioplegic solution, and Group B who received warm blood cardioplegic solution (n=8). Before the aorta was clamped, and 10 min after reperfusion, blood samples from the coronary sinus were obtained to assay alpha-tocopherol, beta-carotene, ubiquinol, and thiobarbituric acid reactive substances (TBARS). At the same intervals, biopsies from the left ventricle were obtained to determine ultrastructural alterations.
  
  
  RESULTS
  No significant changes were observed between preischemia and reperfusion values for both blood and crystalloid groups concerning alpha-tocopherol, beta-carotene, and ubiquinol, and no differences between groups were detected. Values for TBARS in group A were 3.49+/-0.3 and 5.27+/-0.45 microM for presichemia and reperfusion samples, respectively (P<0.01). In group B values were 2.6+/-0.3 and 3.54+/-0.3 microM, respectively (P=NS). For electron microscopy studies, semiquantitative analysis showed a significant mitochondrial damage in reperfusion biopsies from group A (grades 0, 3 and 4). In group B, no significant changes were observed in mitochondrial damage between preischemia and repefusion biopsies (except for grade 0).
  
  
  CONCLUSIONS
  These results indicate that blood cardioplegia affords better protection to the myocyte than crystalloid cardioplegia.
authors.affiliation: Hospital Militar Central, Buenos Aires, Argentina.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Ferreira
authors.forename: César
authors.initials: C
authors.lastname: Fraga
authors.forename: Fernando
authors.initials: F
authors.lastname: Carrasquedo
authors.forename: Héctor
authors.initials: H
authors.lastname: Hourquebie
authors.forename: Daniel
authors.initials: D
authors.lastname: Grana
authors.forename: José
authors.initials: J
authors.lastname: Milei
mesh_terms: D000975:Antioxidants / Q000378:metabolism; D002314:Cardioplegic Solutions; D001026:Coronary Artery Bypass; D006324:Heart Arrest, Induced / Q000379:methods*; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008854:Microscopy, Electron; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D018384:Oxidative Stress; D017680:Potassium Compounds; D017392:Thiobarbituric Acid Reactive Substances / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D000975:Antioxidants; D002314:Cardioplegic Solutions; D017680:Potassium Compounds; D017392:Thiobarbituric Acid Reactive Substances; C018369:potassium cardioplegic solution