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Ann Thorac Surg 1991;52:127-130
© 1991 The Society of Thoracic Surgeons

Articles

Influence of allopurinol on cardiac complications in open heart operations

Moheb A. Rashid, MD*, Göran William-Olsson, MD

Department of Thoracic and Cardiovascular Surgery, Sahlgrenska Hospital, Gothenburg University, Gothenburg, Sweden

Accepted for publication April 12, 1991.

* Address reprint requests to Dr Rashid, Department of Thoracic and Cardiovascular Surgery, Sahlgrenska Hospital, Gothenburg University, 413 45 Gothenburg, Sweden.

During cardiac operations, the heart is subjected to total ischemia and reperfusion, causing serious operative and postoperative complications such as arrhythmias, heart failure, and infarctions that may be partly due to free radical generation. Thus, allopurinol was tested to see if it could reduce cardiac complications during open heart operations. Ninety patients undergoing elective coronary artery bypass grafting were studied prospectively. Fortyfive patients were treated with allopurinol and 45 patients acted as controls. Treatment requiring arrhythmias in the allopurinol group was 6.6% compared with 33.3% in the control group (p < 0.01). The percentage of patients requiring inotropes was significantly lower in the allopurinol group than in the control group (4.4% versus 26.6%; p < 0.01). Perioperative myocardial infarction did not occur in the allopurinol group but was seen in 8 patients (17.7%) in the control group. Intraaortic balloon pumping was used in 5 control patients (11.1%) but not in the allopurinol group. This study shows that allopurinol decreases significantly the incidence of cardiac complications in open heart operations.




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