Effects of Intermittent Tepid Blood Cardioplegia in Coronary Artery Bypass Grafting.
10.4326/jjcvs.27.6
- VernacularTitle:冠状動脈バイパス手術におけるintermittent tepid blood cardioplegiaの心筋保護効果の検討
- Author:
Masaki Miyamoto
;
Bungo Shirasawa
;
Yoshihiro Hayashi
;
Yasuhiro Kouchi
;
Hiroshi Miyashita
;
Atsushi Seyama
;
Kensuke Esato
- Publication Type:Journal Article
- Keywords:
intermittent tepid blood cardioplegia
- From:Japanese Journal of Cardiovascular Surgery
1998;27(1):6-10
- CountryJapan
- Language:Japanese
-
Abstract:
A total of 56 patients undergoing coronary artery bypass grafting were allocated to two groups: the Cold group (28 patients) with cold (4°C) crystalloid cardioplegia and topical ice slush, and the Tepid group (28 patients) with tepid (32°C) blood cardioplegia delivered intermittently antegrade. The two groups were comparable in terms of preoperative New York Heart Association classification, age, gender, and number of grafts. Intraoperatively, tepid blood cardioplegia was associated with a significantly shorter cardiopulmonary bypass time and nearly uniform return of normal sinus rhythm. Cardiac output after bypass was significantly higher than before bypass only in the Tepid group. The absolute peak levels in the myocardial-specific isoenzyme of creatine kinase were higher in the Cold group (70±8IU/l) than in the Tepid group (31±5IU/l). There was a trend toward reduced incidence of perioperative myocardial infarction (0% versus 7.1%) and need for intraaortic balloon pump support (0% versus 3.6%) associated with the use of tepid blood cardioplegia. Our results suggest that intermittent tepid blood cardioplegia is a safe and effective technique for coronary artery bypass grafting.