[Antegrade warm blood cardioplegia versus cold blood cardioplegia in normothermia in the coronary artery bypass grafting procedures. Troponine I release as a marker of periopertive myocardial ischemia].
Warm myocardial protection has had a strong impact on modern cardiac surgery. The O2 consumption of a heart, arrested by potassium-enriched normothermic blood is 90% less than baseline values. Hypothermia gives only a slight reduction in oxygene consumption.


OBJECTIVE
was to test the quality of myocardial protection provided by intermittent antegrade warm blood cardioplegia (IAWBC) by comparing it with cold blood cardioplegia.


METHODS
We designed a prospective randomized study by using 2 different temperatures of blood cardioplegia: warm, from 35 degrees C to 37 degrees C (group I--36 men and 14 women, mean age 56 +/- 7); and cold, from 6 degrees C to 8 degrees C (group II--40 men and 10 women, mean age 58 +/- 9). Cardiac troponin I release was the criterion used to evaluate the adequacy of myocardial protection,


RESULTS
The heartbeat in 92% of patients treated with warm cardioplegia converted to normal sinus rhythm spontaneously after removal of the aortic crossclamp compared with only 18% of the cold cardioplegia group. Cardiac troponin I concentration was significantly higher in the cold group. Our study demonstrates a significant reduction of myocardial cell damage with the use of IAWBC.


CONCLUSIONS
Our clinical results have shown that IAWBC is a superior method compared to intermittent cold cardioplegia.
Skarysz
Janusz
J
Slaska Akademia Medyczna w Katowicach, I Klinika Kardiochirurgii.
Krejca
Michał
M
Szmagała
Przemysław
P
Ulczok
Rafał
R
Bochenek
Andrzej
A
D015415:Biomarkers / Q000097:blood; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006324:Heart Arrest, Induced / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000175:diagnosis* / Q000517:prevention & control*; D009206:Myocardium / Q000378:metabolism*; D010101:Oxygen Consumption; D011446:Prospective Studies; D013696:Temperature; D019210:Troponin I / Q000378:metabolism*
D015415:Biomarkers; D019210:Troponin I