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Ann Thorac Surg 1982;33:421-433
© 1982 The Society of Thoracic Surgeons

Articles

Clinical Evaluation of the Relative Effectiveness of Multidose Crystalloid and Cold Blood Potassium Cardioplegia in Coronary Artery Bypass Graft Surgery: A Nonrandomized Matched-Pair Analysis

Arthur J. Roberts, M.D.*, John M. Moran, M.D., John H. Sanders, M.D., Stewart M. Spies, M.D., Peter R. Lichtenthal, M.D., Kerry J. Kaplan, M.D., Lawrence L. Michaelis, M.D.

From the Divisions of Cardiothoracic Surgery, Cardiology, Anesthesia, and Nuclear Medicine, Northwestern University Medical School, Chicago, IL

Accepted for publication September 17, 1981.

* Address reprint requests to Dr. Roberts, Director of Adult Cardiac Surgery, Division of Thoracic & Cardiovascular Surgery, J. Hillis Miller Health Center, University of Florida, Gainesville, FL 32610

Controversy exists concerning the most effective method of myocardial protection during coronary artery bypass graft operations. Accordingly, we performed a matched-pair analysis between 25 patients receiving multidose hypothermic potassium crystalloid cardioplegia and 25 other patients receiving cold blood potassium cardioplegia. Patients were matched on the basis of preoperative ejection fraction (EF) and the number of anatomically similar stenotic coronary arteries. The adequacy of myocardial protection was assessed by serial perioperative determinations of radionuclide ventriculography, hemodynamic measurements, analyses of electrocardiograms, and serum levels of MB-CK. We found that the level of myocardial protection was similar between unstratified groups. However, when subgroups were selected on the basis of prolonged aortic cross-clamp time (> ninety minutes) or impaired preoperative left ventricular function (EF < 40%), there was a suggestion that cold blood cardioplegia may be advantageous.




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