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The Annals of Thoracic Surgery, Vol 37, 319-323, Copyright © 1984 by The Society of Thoracic Surgeons
GL Hicks Jr, RK Salley and JA DeWeese
This study analyzes the effects of intraoperative and postoperative calcium
channel blockers on myocardial protection, postoperative arrhythmias,
perioperative infarctions, and survival. Thirty-nine women undergoing
consecutive coronary artery bypass operations were placed either in a
control group (N = 23), in which standard cold potassium cardioplegia was
used, or in a verapamil-nifedipine group (N = 16), in which verapamil (1 mg
per liter) was added to the standard cardioplegic solution and nifedipine
was instituted postoperatively. The verapamil- nifedipine group showed a
significant reduction in postoperative levels of creatine phosphokinase (p
less than 0.05). Levels of aspartate aminotransferase were also reduced (74
IU/L) compared with those for the control group (114 IU/L). In the control
group, there were 3 early deaths secondary to abrupt ventricular
fibrillation, but no patient in the verapamil-nifedipine group died or had
serious early ventricular arrhythmias. Late hemodynamic variables were
similar in both groups. We conclude that calcium channel blockers enhance
myocardial protection during ischemic arrest and may diminish the incidence
of fatal early postoperative ventricular arrhythmias in women undergoing
coronary revascularization.
ARTICLES
Calcium channel blockers: an intraoperative and postoperative trial in women
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