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Ann Thorac Surg 1995;59:398-402
© 1995 The Society of Thoracic Surgeons

Orginal Articles

Intermittent Antegrade Warm Blood Cardioplegia

Antonio M. Calafiore, MD, Giovanni Teodori, MD, Andrea Mezzetti, MD, Giovanni Bosco, MD, Anna Maria Verna, Ccp, Gabriele Di Giammarco, MD, Domenico Lapenna, MD

Departments of Cardiac Surgery, Medical Pathophysiology, and Anesthesia, ``G. D'Annunzio'' Chieti University, Chieti, Italy

Accepted for publication September 23, 1994.

Abstract

Intermittent antegrade warm blood cardioplegia has been used routinely at our institution over the last 3 years. We report here a comparison between the first 250 consecutive patients undergoing elective coronary artery bypass grafting in which intermittent antegrade warm blood cardioplegia was used (group A) and the last 250 consecutive patients who received intermittent antegrade cold blood cardioplegia, during bypass grafting (group B). There were no differences in sex, age, number of grafts, and functional status between the two groups; left ventricular ejection fraction was lower in group A. The overall mortality rate in group A was 0.8% versus 3.6% in group B (p < 0.05). There was no in-hospital mortality among high-risk patients (ejection fraction <= 0.35) in group A (0/53) versus two deaths in group B (2/28) (p < 0.05). No patient in group A needed circulatory assistance; 4 patients in group B received intraaortic balloon pumping. Only 1 patient in group A required inotropic support versus 20 patients in group B (p < 0.0005), and 5 patients in group A received lidocaine hydrochloride for ventricular arrhythmias versus 18 in group B (p < 0.01). The rates of myocardial infarction and stroke were not different between the two groups. The peak concentration of the myocardial-specific isoenzyme of creatine kinase were higher in group B in absolute value (51 ± 30 IU/L) than in group A (38 ± 38 IU/L) (p < 0.0005) and in percent of total creatine kinase (8.2% ± 4.1% versus 6.2% ± 2.9%, respectively). Group A patients awoke earlier (2.7 ± 1.5 hours versus 3.9 ± 2.8 hours; p < 0.0005) and had a shorter stay in the intensive care unit (28 ± 7 hours versus 43 ± 10 hours; p < 0.0005) than group B patients. We conclude that intermittent antegrade warm blood cardioplegia is a safe, reliable, and effective technique of myocardial protection that deserves further assessment.




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Ann. Thorac. Surg., March 1, 1998; 65(3): 615 - 621.
[Abstract] [Full Text] [PDF]

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 J. Thorac. Cardiovasc. Surg.Home page
N. C. de Oliveira, T. J. Boeve, D. F. Torchiana, H. L. Kantor, J. S. Titus, C. J. Schmidt, C.-z. Lu, J. Kim, W. M. Daggett, and G. A. Geffin
ISCHEMIC INTERVALS DURING WARM BLOOD CARDIOPLEGIA IN THE CANINE HEART EVALUATED BY PHOSPHORUS 31-MAGNETIC RESONANCE SPECTROSCOPY
J. Thorac. Cardiovasc. Surg., December 1, 1997; 114(6): 1070 - 1080.
[Abstract] [Full Text]

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 Ann. Thorac. Surg.Home page
D. Curro, G. Bombardieri, C. Barilaro, P. Di Francesco, C. Varano, G. Possati, and C. Pragliola
Time Dependence of Endothelium-Mediated Vasodilation by Intermittent Antegrade Warm Blood Cardioplegia
Ann. Thorac. Surg., November 1, 1997; 64(5): 1354 - 1359.
[Abstract] [Full Text]

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 Ann. Thorac. Surg.Home page
M. Chello, P. Mastroroberto, V. De Amicis, D. Pantaleo, R. Ascione, and N. Spampinato
Intermittent Warm Blood Cardioplegia Preserves Myocardial {beta}-Adrenergic Receptor Function
Ann. Thorac. Surg., March 1, 1997; 63(3): 683 - 688.
[Abstract] [Full Text]

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

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 Ann. Thorac. Surg.Home page
L. Torracca, E. Pasini, S. Curello, C. Ceconi, G. Coletti, O. Alfieri, R. Solfrini, and R. Ferrari
Continuous Versus Intermittent Warm Blood Cardioplegia: Functional and Energetics Changes
Ann. Thorac. Surg., October 1, 1996; 62(4): 1172 - 1179.
[Abstract] [Full Text]

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 Ann. Thorac. Surg.Home page
G. Mastrogiovanni, P. Masiello, S. Iesu, I. Senese, and G. Di Benedetto
Management of Cold Agglutinemia With Intermittent Warm Blood Cardioplegia and Normothermia
Ann. Thorac. Surg., July 1, 1996; 62(1): 317 - 317.
[Full Text]

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S. V. Lichtenstein, C. D. Naylor, C. M. Feindel, K. Sykora, J. G. Abel, A. S. Slutsky, C. D. Mazer, G. T. Christakis, B. S. Goldman, and S. E. Fremes
Intermittent Warm Blood Cardioplegia
Circulation, November 1, 1995; 92(9): 341 - 346.
[Abstract] [Full Text]

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 Ann. Thorac. Surg.Home page
A. M. Calafiore, G. Di Giammarco, G. Teodori, E. D'Annunzio, G. Vitolla, C. Fino, and N. Maddestra
Radial Artery and Inferior Epigastric Artery in Composite Grafts: Improved Midterm Angiographic Results
Ann. Thorac. Surg., September 1, 1995; 60(3): 517 - 523.
[Abstract] [Full Text]


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