title: Improvement in cardioplegic perfusion technique in single aortic clamping - initial results.
abstract: BACKGROUND
  The most common method used for myocardial protection is administering cardioplegic solution in the coronary circulation. Nevertheless, protection may be achieved by intermittent perfusion of the coronary system with patient's own blood. The intermittent perfusion may be performed by multiple sequences of clamping and opening of the aortic clamp or due single clamping and accessory cannulation of the aortic root as in the improved technique proposed in this study, reperfusion without the need for multiple clamping of the aorta.
  
  
  OBJECTIVE
  To evaluate the clinical outcome and the occurrence of neurological events in in-hospital patients submitted to myocardial revascularization surgery with the "improved technique" of intermittent perfusion of the aortic root with single clamping.
  
  
  METHODS
  This is a prospective, cross-sectional, observational study that describes a myocardial management technique that consists of intermittent perfusion of the aortic root with single clamping in which 50 patients (mean age 58.5 ± 7.19 years old) have been submitted to the myocardial revasculrization surgery under the proposed technique. Clinical and laboratory variables, pre- and post-surgery, have been assessed.
  
  
  RESULTS
  The mean peak level of post-surgery CKMB was 51.64 ± 27.10 U/L in the second post-surgery and of troponin I was 3.35 ± 4.39 ng/ml in the fourth post-surgery, within normal limits. No deaths have occurred and one patient presented mild neurological disorder. Hemodynamic monitoring has not indicated any changes.
  
  
  CONCLUSIONS
  The myocardial revascularization surgery by perfusion with the improved technique with intermittent aortic root with single clamping proved to be safe, enabling satisfactory clinical results.
authors.affiliation: Real e Benemérita Associação Portuguesa de São Paulo, São Paulo, SP, Brasil.
authors.forename: Marcelo Luiz Peixoto
authors.initials: ML
authors.lastname: Sobral
authors.affiliation: Santa Casa de Itabuna, Itabuna, BA, Brasil.
authors.forename: Sérgio Francisco dos
authors.initials: SF
authors.lastname: Santos Júnior
authors.affiliation: Hospital Santa Izabel, Salvador, BA, Brasil.
authors.forename: Juliano Cavalcante de
authors.initials: JC
authors.lastname: Sá
authors.affiliation: Hospital Universitário Francisca Mendes, Manaus, AM, Brasil.
authors.forename: Anderson da Silva
authors.initials: Ada S
authors.lastname: Terrazas
authors.affiliation: Real e Benemérita Associação Portuguesa de São Paulo, São Paulo, SP, Brasil.
authors.forename: Daniel Francisco de Mendonça
authors.initials: DF
authors.lastname: Trompieri
authors.affiliation: Real e Benemérita Associação Portuguesa de São Paulo, São Paulo, SP, Brasil.
authors.forename: Thierry Araújo Nunes de
authors.initials: TA
authors.lastname: Sousa
authors.affiliation: Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Gilmar Geraldo dos
authors.initials: GG
authors.lastname: Santos
authors.affiliation: Instituto do Coração da Faculdade de Medicina da Universidade Dde São Paulo (FMUSP), São Paulo, SP, Brasil., São Paulo, SP, Brasil.
authors.forename: Noedir Antonio Groppo
authors.initials: NA
authors.lastname: Stolf
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000601:surgery*; D002314:Cardioplegic Solutions / Q000008:administration & dosage; D003250:Constriction; D001026:Coronary Artery Bypass / Q000379:methods*; D003326:Coronary Circulation; D003430:Cross-Sectional Studies; D005260:Female; D006324:Heart Arrest, Induced / Q000379:methods*; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods*; D019157:Ischemic Preconditioning, Myocardial / Q000379:methods*; D008297:Male; D008488:Medical Illustration; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002314:Cardioplegic Solutions