| Complex valve operations: antegrade versus retrograde cardioplegia? | |
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MedLine Citation:
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PMID: 7677539 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Increasingly complex cardiac procedures demand optimal myocardial protective techniques during the requisite interval of aortic cross-clamping. For complex procedures in which prolonged cross-clamp times are anticipated, we favor combined antegrade and retrograde cold blood cardioplegia. Advantages include rapid arrest, uniform distribution, and an uninterrupted operation. METHODS: We retrospectively evaluated the cases of 194 consecutive patients who underwent complex cardiovascular procedures between January 1988 and October 1994. Procedures performed included valve repair and coronary artery bypass grafting (23.7%), valve replacement and coronary artery bypass grafting (19.1%), complex aortic arch and valve procedures (16.6%), valve repair only (16.5%), reoperative valve (9.8%), and multiple-valve replacements (9.3%). Cardioplegic arrest times averaged 113 +/- 38.5 minutes (range, 52 to 292 minutes). RESULTS: Postoperative left and right ventricular function was evaluated using transesophageal echocardiography. The echocardiograms revealed a 3.1% incidence of new left ventricular dysfunction and no case of right ventricular dysfunction. Of the patients evaluated, 75.7% required little (< 3 micrograms.kg-1.min-1 of dopamine hydrochloride) or no inotropic support postoperatively. The 30-day mortality rate was 3.1%, and no death was due to cardiac failure. CONCLUSIONS: We conclude that myocardial protection using a combined antegrade and retrograde cardioplegia technique permits excellent myocardial protection during complex cardiovascular procedures requiring long arrest times. |
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Authors:
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W R Chitwood; C L Wixon; T O Norton; R M Lust |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 60 ISSN: 0003-4975 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 1995 Sep |
Date Detail:
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Created Date: 1995-10-19 Completed Date: 1995-10-19 Revised Date: 2010-03-24 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 815-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, East Carolina University School of Medicine, Greenville, North Carolina 27858, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Aorta Aorta, Thoracic / surgery Aortic Valve / surgery Blood Cardioplegic Solutions Cardiopulmonary Bypass Cardiotonic Agents / administration & dosage, therapeutic use Cold Temperature Constriction Coronary Artery Bypass* Echocardiography, Transesophageal Heart Arrest, Induced / methods* Heart Valves / surgery* Humans Middle Aged Reoperation Retrospective Studies Survival Rate Time Factors Ventricular Dysfunction, Left / etiology, ultrasonography Ventricular Function, Right |
| Chemical | |
Reg. No./Substance:
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0/Cardioplegic Solutions; 0/Cardiotonic Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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