Comparison between warm blood and crystalloid cardioplegia during open heart surgery.
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.
Ferreira
Ricardo
R
Hospital Militar Central, Buenos Aires, Argentina.
Fraga
César
C
Carrasquedo
Fernando
F
Hourquebie
Héctor
H
Grana
Daniel
D
Milei
José
J
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
D000975:Antioxidants; D002314:Cardioplegic Solutions; D017680:Potassium Compounds; D017392:Thiobarbituric Acid Reactive Substances; C018369:potassium cardioplegic solution