Document Detail


A prospective randomised study of continuous warm versus intermittent cold blood cardioplegia for coronary artery surgery: preliminary report.
MedLine Citation:
PMID:  8043290     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Between October 1991 and March 1993, 281 consecutive patients underwent non-emergency isolated coronary artery surgery under the care of one surgeon (A.R.). They were prospectively randomised to receive either intermittent cold (Group I-144 patients) or continuous warm (Group II-137 patients) blood cardioplegia for myocardial protection. There were no significant differences in clinical outcome between the two groups, as judged by operative mortality, rates of peri-operative myocardial infarction, blood loss, need for circulatory support, post-operative neurological deficit, or duration of intensive care or hospital stay. However, sinus rhythm returned spontaneously with greater frequency (91.2% vs 45.8%, P < 0.001) in Group II patients. There was greater transmyocardial oxidative stress in Group I patients, as evidenced by a significant rise in oxidised glutathione in coronary sinus blood on myocardial reperfusion. Also, the serum CKMb isoenzyme level 2 h post-operatively was significantly raised in Group I patients, although this difference had disappeared by the day after surgery. In conclusion this preliminary report suggests that continuous warm blood cardioplegia provides comparable myocardial protection to that achieved with standard hypothermic techniques in patients undergoing coronary artery surgery.
Authors:
A Rashid; B M Fabri; M Jackson; M J Desmond; E D Grech; S A Battistessa; R D Page
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
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:  1994-09-01     Completed Date:  1994-09-01     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:  265-9     Citation Subset:  IM    
Affiliation:
Cardiothoracic Centre, Liverpool, UK.
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MeSH Terms
Descriptor/Qualifier:
Coronary Angiography
Coronary Artery Bypass / methods*
Creatine Kinase / blood
Female
Glutathione / analogs & derivatives,  blood
Glutathione Disulfide
Heart / physiopathology*
Heart Arrest, Induced / adverse effects,  methods*
Humans
Isoenzymes
Male
Middle Aged
Myocardium / metabolism
Postoperative Complications / mortality
Prospective Studies
Temperature
Treatment Outcome
Chemical
Reg. No./Substance:
0/Isoenzymes; 27025-41-8/Glutathione Disulfide; 70-18-8/Glutathione; EC 2.7.3.2/Creatine Kinase

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


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