Clinical Evaluation of the Relative Effectiveness of Multidose Crystalloid and Cold Blood Potassium Cardioplegia in Coronary Artery Bypass Graft Surgery: A Nonrandomized Matched-Pair Analysis
1982; Elsevier BV; Volume: 33; Issue: 5 Linguagem: Inglês
10.1016/s0003-4975(10)60780-1
ISSN1552-6259
AutoresArthur J. Roberts, John M. Moran, John H. Sanders, Stewart Spies, Peter R. Lichtenthal, Kerry Kaplan, Lawrence L. Michaelis,
Tópico(s)Cardiac Arrest and Resuscitation
ResumoControversy exists concerning the most effective method of myocardial protection during coronary artery bypass graft operations.Ac- cordingly, we performed a matched-pair analysis between 25 patients receiving multidose hypothermic potassium crystalloid cardioplegia and 25 other patients receiving cold blood potassium cardioplegia.Patients were matched on the basis of preoperative ejection fraction (EF) and the number of anatomically similar stenotic coronary arteries.The adequacy of myocardial protection was assessed by serial perioperative determinations of radionuclide ventriculography, hemodynamic measurements, analyses, of electrocardiograms, and serum levels of MB-CK.We found that the level of myocardial protection was similar between unstratified groups.However, when subgroups were selected on the basis of prolonged aortic cross-clamp time (> ninety minutes) or impaired preoperative left ventricular function (EF < 4O0/o), there was a suggestion that cold blood cardioplegia may be advantageous.Coronary artery bypass grafting (CABG) operations are increasing in frequency [ll and relieve angina pectoris in the great majority of patients [21.Furthermore, these procedures definitely prolong life in patients with left main coronary artery disease [3] and may increase longevity in certain other subsets of patients with coronary
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