Document Detail


Is continuous warm retrograde blood cardioplegia completely safe for coronary artery surgery?
MedLine Citation:
PMID:  7893494     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Sixty consecutive coronary patients operated on by the same team in 1992 were divided into two groups: group 1 (30 patients) using intermittent oxygenated cold Fresenius solution antegrade and retrograde (FR), group 2 (30 patients) using warm retrograde blood cardioplegia (WRC) with the Fremes solution initially antegrade and retrograde (high potassium solution) then continuous retrograde low potassium solution. All patients were submitted to only arterial grafts (3 to 4) using both internal mammary arteries and the the right gastroepiploic artery. There were no differences in mean preoperative data between the 2 groups. The times of aortic cross-clamping (P < 0.05) and bypass after release of the aortic clamp (P < 0.01) were significantly higher in the WRC group. No significant difference was observed in the number of postoperative supraventricular arrhythmias or electrocardiographic infarctions. A significant difference was observed with higher values of the enzymes (aspartate amino transferase, creatine kinase) for the WRC group on the first (P < 0.05) and the second postoperative days (P < 0.01). More patients in the WRC group received vasoactive or inotropic drugs in the intensive care unit, where they stayed a longer time because of hemodynamic instability or enzyme elevation (P < 0.05). In conclusion, for coronary arterial revascularization, WRC is technically more demanding and does not appear to afford optimal myocardial protection.
Authors:
P Mikaeloff; O Jegaden; P Montagna; J Ossete; P Desseigne; A Eker; R Loire; R Rossi
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  8     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  1994  
Date Detail:
Created Date:  1995-04-21     Completed Date:  1995-04-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  569-74; discussion 574-5     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Hospital for Cardiovascular Diseases, Lyon, France.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aspartate Aminotransferases / blood
Cardioplegic Solutions*
Cardiopulmonary Bypass / methods*
Constriction
Coronary Disease / blood,  surgery*
Creatine Kinase / blood
Female
Heart Arrest, Induced / methods*
Humans
Male
Middle Aged
Postoperative Care
Postoperative Complications / mortality
Rewarming
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Cardioplegic Solutions; EC 2.6.1.1/Aspartate Aminotransferases; EC 2.7.3.2/Creatine Kinase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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