title: Myocardial Protection with multiport antegrade cold blood cardioplegia and continuous controlled warm shot through vein grafts during proximal ends anastomosis in conventional coronary artery bypass graft.
abstract: OBJECTIVE
  To evaluate the benefits of simultaneous aortic root and vein graft cold blood cardioplegia and continuous controlled warm blood perfusion through vein grafts during proximal aortocoronary anastomosis in conventional coronary artery bypass graft surgery in patients with multi-vessel coronary artery disease.
  
  
  METHODS
  The prospective randomised study was conducted at Chaudary Pervaiz Elahi Institute of Cardiology, Multan, Pakistan, from April 2013 to June 2014, and comprised patients of isolated conventional coronary artery bypass graft surgery. The patients were randomised into 2 groups; Group I had patients in whom multiperfusion set was used for cardioplegia and continuous warm blood perfusion through vein grafts during proximal ends anastomosis, and Group II had patients in whom routine aortic root antegrade cardioplegia was used with no warm blood perfusion during proximal anastomosis of vein grafts. Data was analysed using SPSS 20.
  
  
  RESULTS
  There were 434 patients in the study, with Group 1 having 215(49.5%) being the study group, and Group II having 219(50.5%)being the Control group. The groups showed no significant difference in the number of grafts, and aortic cross-clamp time (p>0.05 each). Total bypass time was significantly prolonged in the Control Group (p=0.001). Incidence of intra-operative arrhythmias, peri-operative myocardial infarction, need for inotropic support and intra-aortic balloon counter-pulsation and operative mortality were significantly higher in the Control group (p<0.05 each).
  
  
  CONCLUSIONS
  Simultaneous aortic root and vein graft cold blood cardioplegia and continuous controlled warm blood perfusion was beneficial for myocardial protection and early patient outcome.
authors.affiliation: Department of Cardiac Surgery, Chaudary Pervaiz Elahi Institute of Cardiology, Multan, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Sher-I-Murtaza
authors.affiliation: Department of Cardiac Surgery, Chaudary Pervaiz Elahi Institute of Cardiology, Multan, Pakistan.
authors.forename: Hafiz Muhammad Farhan
authors.initials: HM
authors.lastname: Ali Rizvi
authors.affiliation: Department of Cardiac Surgery, Chaudary Pervaiz Elahi Institute of Cardiology, Multan, Pakistan.
authors.forename: Mirza Ahmad
authors.initials: MA
authors.lastname: Raza Baig
authors.affiliation: Department of Cardiac Surgery, Chaudary Pervaiz Elahi Institute of Cardiology, Multan, Pakistan.
authors.forename: Waqas
authors.initials: W
authors.lastname: Hamid
authors.affiliation: Department of Cardiac Surgery, Chaudary Pervaiz Elahi Institute of Cardiology, Multan, Pakistan.
authors.forename: Haider
authors.initials: H
authors.lastname: Zaman
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000453:epidemiology; D003080:Cold Temperature; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D006324:Heart Arrest, Induced / Q000379:methods*; D006358:Hot Temperature; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology
keywords: Coronary artery bypass graft surgery, Myocardial protection, Cardioplegia, Multi perfusion adapter.