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

This Article Alert me when this article is cited Alert me if a correction is posted 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 HighWire Citing Articles via Google Scholar Google Scholar Articles by Menasche, P. Articles by Bloch, G. Search for Related Content PubMed PubMed Citation Articles by Menasche, P. Articles by Bloch, G.

The Annals of Thoracic Surgery, Vol 56, 1148-1153, Copyright © 1993 by The Society of Thoracic Surgeons

ARTICLES

Limitation of vasodilation associated with warm heart operation by a "mini-cardioplegia" delivery technique

P Menasche, JP Fleury, L Veyssie, O Le Dref, B Touchot, AH Piwnica and G Bloch
Department of Cardiovascular Surgery, Hopital Lariboisiere, Paris, France.

Peripheral vasodilation is commonly seen during and after warm heart operations and can become of clinical concern when it requires vasopressors because some of these drugs adversely affect coronary artery bypass graft flows. As hemodilution lowers systemic vascular resistance, we assessed whether peripheral vasodilation could be limited by a drastic reduction of the volume of infused cardioplegia. Fifty patients underwent isolated coronary artery bypass grafting procedures using normothermic (35 degrees to 37 degrees C) bypass and normothermic continuous retrograde blood cardioplegia. They were divided into two equal groups: in group 1, blood was diluted 4:1 with hyperkalemic crystalloid cardioplegia, whereas in group 2, the cardioplegic "solution" was limited to the sole arresting agents that were concentrated in a small volume (16 mEq potassium chloride and 3 mEq magnesium chloride in a 20-mL ampoule). This "mini-cardioplegia" was continuously added to arterial blood so as to keep the heart arrested. The average volume of cardioplegia per patient was 1,000 mL in group 1 and 58 mL in group 2 (p < 0.0001). The mini-cardioplegia technique resulted in a reduced incidence of perioperative systemic vasodilation: group 2 patients required significantly less vasopressors (p < 0.05) and less volume loading, as reflected by significantly lower right atrial and pulmonary capillary wedge pressures (p < 0.05 and p < 0.03 at 12 hours postoperatively, respectively), compared with group 1 patients who received traditional high-volume cardioplegia. There were no differences between the two groups with respect to myocardial recovery, as assessed by standard clinical and hemodynamic end points.(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				N. Hayashida, T. Isomura, T. Sato, H. Maruyama, T. Higashi, K. Arinaga, and S. Aoyagi Minimally Diluted Tepid Blood Cardioplegia Ann. Thorac. Surg., March 1, 1998; 65(3): 615 - 621. [Abstract] [Full Text] [PDF]

				P. Menasche Blood Cardioplegia: Do We Still Need to Dilute? Ann. Thorac. Surg., October 1, 1996; 62(4): 957 - 960. [Full Text]

				I. Birdi, M. B. Izzat, A. J. Bryan, and G. D. Angelini Normothermic Techniques During Open Heart Operations Ann. Thorac. Surg., May 1, 1996; 61(5): 1573 - 1580. [Abstract] [Full Text]