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The Annals of Thoracic Surgery, Vol 33, 421-433, Copyright © 1982 by 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

AJ Roberts, JM Moran, JH Sanders, SM Spies, PR Lichtenthal, KJ Kaplan and LL Michaelis

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 (greater than ninety minutes) or impaired preoperative left ventricular function (EF less than 40%), there was a suggestion that cold blood cardioplegia may be advantageous.


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