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The Annals of Thoracic Surgery, Vol 50, 771-775, Copyright © 1990 by The Society of Thoracic Surgeons
AC Fiore, KS Naunheim, J Taub, P Braun, LR McBride, DG Pennington, GC Kaiser, VL Willman and HB Barner
Prevention of ventricular fibrillation after aortic unclamping using
lidocaine hydrochloride as an additive to cold potassium blood cardioplegia
was studied prospectively in 46 patients undergoing elective myocardial
revascularization. Patients were similar with respect to age, ventricular
function, severity of coronary artery disease, cross-clamp time,
completeness of revascularization, frequency of internal thoracic artery
grafting, systemic temperature at the time of cross-clamp removal, and mean
infusate volume and temperature. Patients receiving lidocaine blood
cardioplegia (group 1, 23 patients) had a significant reduction in the
incidence of ventricular fibrillation (22% versus 74%; p less than 0.0005)
and in the mean number of cardioversion attempts required to defibrillate
the heart (0.5 +/- 1.3 versus 1.9 +/- 0.97; p less than 0.0005) after
cross-clamp removal compared with controls (group 2, 23 patients). There
were no differences between the two groups postoperatively with regard to
cardiac enzyme release, hemodynamic measurements, or clinical outcome.
Patients receiving lidocaine blood cardioplegia tended to have a lower
incidence of new postoperative atrial fibrillation (9% versus 26%).
Ventricular function was preserved equally in both groups. We conclude that
lidocaine is a safe additive to potassium blood cardioplegia and
significantly reduces the incidence of ventricular fibrillation after
aortic unclamping.
ARTICLES
Myocardial preservation using lidocaine blood cardioplegia
Department of Surgery, St. Louis University Medical Center, MO 63110- 0250.
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E. Ovrum, G. Tangen, E. A. Holen, M.-A. L. Ringdal, and R. Istad Conversion of Postischemic Ventricular Fibrillation With Intraaortic Infusion of Potassium Chloride Ann. Thorac. Surg., July 1, 1995; 60(1): 156 - 159. [Abstract] [Full Text] |
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