Warm blood cardioplegia versus cold crystalloid cardioplegia for myocardial protection during coronary artery bypass grafting surgery (original) (raw)

2018, Cell death discovery

We retrospectively analyzed early results of coronary artery bypass grafting (CABG) surgery using two different types of cardioplegia for myocardial protection: antegrade intermittent warm blood or cold crystalloid cardioplegia. From January 2015 to October 2016, 330 consecutive patients underwent isolated on-pump CABG. Cardiac arrest was obtained with use of warm blood cardioplegia (WBC group, = 297) or cold crystalloid cardioplegia (CCC group, = 33), according to the choice of the surgeon. Euroscore II and preoperative characteristics were similar in both groups, except for the creatinine clearance, slightly lower in WBC group (77.33 ± 27.86 mL/min versus 88.77 ± 51.02 mL/min) ( < 0.05). Complete revascularization was achieved in both groups. In-hospital mortality was 2.0% ( = 6) in WBC group, absent in CCC group. The required mean number of cardioplegia's doses per patient was higher in WBC group (2.3 ± 0.8) versus CCC group (2.0 ± 0.7) ( = 0.045), despite a lower number...

Warm Versus Cold Intermittent Blood Cardioplegia for Myocardial Protection During On-Pump Coronary Artery Bypass Grafting

Ain Shams medical journal, 2020

Background: Obtaining an optimal surgical result depends on performing a technically proficient operation while protecting the heart from potential damage. Cardioplegia is an essential component in myocardial protection during aortic cross-clamping and cardiopulmonary bypass. The development of cardioplegia solutions is one of the major advances in cardiac surgery that allowed surgeons to extend the period of ischemic arrest to well over 3 hours to perform complex surgical procedures without adversely affecting myocardial functio).Aim of the work: We sought to compare between two specific modalities of myocardial protection using either intermittent ante-grade cold blood cardioplegia or warm blood cardioplegia.Patients and Methods: This prospective study included 200 successive adult patients who have undergone elective on-pump coronary artery bypass grafting (CABG) operations. Randomization was done immediately before the beginning of the operation so that group allocation was blin...

Comparison Study: Intermittent Antigrade Warm Cardioplegia Versus Antigrade Cold Intermittent Blood Cardioplegia for Myocardial Protection During Elective on Pump Coronary Artery Bypass Grafting in Early Post-Operative Period

International Journal of Advanced Research, 2020

Background: Defending the heart against potential damage during cross-clamping is the most important and vital step to ensuring a successful surgical outcome(1). The creation of cardioplegia solutions was one of the major advances in cardiac surgery that allowed surgeons to conduct complicated surgical procedures to avoid myocardial injury (14). Treating cardioplegia at a cool temperature would be a significant factor in lowering myocardial metabolism. However, the reduction in myocardial metabolism due to hypothermia, compared with that achieved by diastolic arrest, is usually very negligible. Since Normothermias enzymatic and cellular processes work better (7). Owing to the propensity of the heart to resume electrical operation during normothermia, however, this must be administered consistently or only with short interruptions (4). Terminal warm blood cardioplegia (hot shot) is normally done just before the elimination of the aortic cross-clamp since it has been demonstrated that...

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

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-operativemyocardial 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.

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