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Ann Thorac Surg 1992;53:628-634
© 1992 The Society of Thoracic Surgeons

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Articles

Initial experience with low-potassium cold blood cardioplegia: A clinical comparative study

Departments of Cardiovascular and Thoracic Surgery, Anesthesiology, Intensive Care, and Biostatistics, Academic Hospital of Mont-Godinne (Catholic University of Louvain), Yvoir, Belgium

Accepted for publication September 12, 1991.

^_* Address reprint request to Dr Louagie, Cardiovascular and Thoracic Surgery, Academic Hospital of Mont-Godinne, 1 av Therasse, B5530 Yvoir, Belgium.

This study presents the results of bypass grafting in 96 patients operated on for triple-vessel coronary artery disease between May 1988 and September 1990. In the first 54 patients a cold crystalloid solution was employed, and in the 42 more recent patients cold blood low-potassium cardioplegia was employed. There were no differences in postoperative cardiac index or left ventricular stroke work index. Yet, in patients with impaired prebypass left ventricular stroke work index, postbypass left ventricular performance correlated negatively with duration of aortic cross-clamping in the cold crystalloid group (r = –0.441, p = 0.045). In contrast, no correlation was found in the cold blood low-potassium group (r = 0.125, p = 0.587). The incidence of myocardial infarction, need for inotropic support, and need for intraaortic balloon counterpulsation were similar among the groups. Release of the myocardial isoenzyme creatine kinase-MB from 12 to 30 hours after operation was significantly less in the low-potassium blood cardioplegia group. The use of low-potassium blood cardioplegia resulted in a marked reduction in the operative administration of fluids (1,527 ± 87 versus 3,511 ± 148 ml; p < 0.001). In conclusion, low-potassium cold blood cardioplegia is a simple and effective method of myocardial protection. The fact that left ventricular stroke work index recovery was not dependent on the duration of aortic occlusion and that release of the MB isoenzyme of creatine kinase was reduced in the low-potassium blood cardioplegia group implies better myocardial protection.

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