Comparison of simultaneous antegrade/vein graft cardioplegia with antegrade cardioplegia for myocardial protection


Önem G., Sacar M. , Baltalarlı A., OZCAN A. V. , GURSES E., SUNGURTEKIN H.

ADVANCES IN THERAPY, cilt.23, ss.869-877, 2006 (SCI İndekslerine Giren Dergi) identifier identifier identifier

  • Cilt numarası: 23 Konu: 6
  • Basım Tarihi: 2006
  • Doi Numarası: 10.1007/bf02850208
  • Dergi Adı: ADVANCES IN THERAPY
  • Sayfa Sayıları: ss.869-877

Özet

Antegrade cardioplegic delivery via the aorta ensures distribution of cardioplegic solution through open arteries, but distribution may not be adequate beyond a stenotic coronary artery. This potential problem can be overcome by direct delivery of cardioplegia via a vein graft. The purpose of this study was to compare simultaneous antegrade/vein graft cardioplegia with antegrade cardioplegia during coronary artery bypass surgery. Twenty patients were divided into 2 groups. In group 1, intermittent antegrade cardioplegia was provided (n=10). In group 2, intermittent antegrade cardioplegia was supplemented by antegrade perfusion of vein grafts after distal anastomoses were completed (n=10). Data on enzyme release and hemodynamics were obtained preoperatively, before the induction of anesthesia, just before cross-clamping, immediately after aortic unclamping, and at 1, 6, 12, 24, and 48 h after unclamping. Enzyme release (creatinine phosphokinase-isoenzyme MB, cardiac troponin 1, myoglobin) was similar in both groups (P >.05). Furthermore, no significant difference was noted in the incidence of postoperative low cardiac output syndrome, perioperative myocardial infarction, or ventricular arrhythmia (P >.05). In conclusion, both techniques permitted rapid postoperative recovery of myocardial function. Supplementation of antegrade perfusion of vein grafts with antegrade cold blood cardioplegia offered no advantage to study patients. However, hemostasis of a distal anastomosis may be controlled by this technique.