HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Molina, J. E. Articles by Voss, D. M. Search for Related Content PubMed PubMed Citation Articles by Molina, J. E. Articles by Voss, D. M.

Ann Thorac Surg 1982;33:434-444
© 1982 The Society of Thoracic Surgeons

---

Articles

Pressurized Rapid Cardioplegia versus Administration of Exogenous Substrate and Topical Hypothermia

From the Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, and the Departments of Surgery, Biochemistry, and Cardiology, Marshfield Clinic, Marshfield, WI

Accepted for publication October 30, 1981.

^* Address reprint requests to Dr. Molina, University of Minnesota Hospitals, 420 Delaware St, SE, Box 472 Mayo Building, Minneapolis, MN 55455

Five hundred fifty-nine patients undergoing aortocoronary operation were analyzed retrospectively according to the type of myocardial protection implemented during the period of ischemia. In Group 1 (253 patients), a rapid method of hypothermic cardioplegia alone was utilized. In Group 2 (306 patients), slower infusion of the same solution with topical hypothermia was implemented. Cardiac isoenzymes (CPK-MB, LDH₁, LDH₂, serum glutamic oxaloacetic transaminase [SGOT]) and myocardial infarct index (MII) were measured postoperatively for 48 hours.

Immediately after operation, a significant difference was found between Groups 1 and 2 in the CPK-MB isoenzyme mean value levels—12.1 versus 18.6 IU, p < 0.01—and MII mean values—5.2 versus 8.1, p < 0.01. CPK-MB variances between subgroups receiving two, three, and four grafts were significantly different in favor of Group 1. Differences were also found in LDH₁, LDH₂, total lactic dehydrogenase (LDH), and SGOT: Group 2 levels were significantly higher than in Group 1. There were ten intraoperative infarctions in Group 2 and none in Group 1. In 45% of the patients in Group 2, inotropic agents were necessary in the postoperative period versus none in Group 1. Spontaneous cardiac rhythm following ischemia occurred in 89.7% of the patients in Group 1 versus 29% in Group 2. A method of pressurized high-flow rapid cardioplegia with intermittent reperfusions alone, seems to provide adequate protection of the myocardium during ischemia over a slower low-flow method of infusion combined with topical hypothermia.