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

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map 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 Alhan, H. C. Articles by Yigiter, B. Search for Related Content PubMed PubMed Citation Articles by Alhan, H. C. Articles by Yigiter, B.

Ann Thorac Surg 1996;61:834-839
© 1996 The Society of Thoracic Surgeons

---

Original Articles: Cardiovascular

Intermittent Aortic Cross-Clamping and Cold Crystalloid Cardioplegia for Low-Risk Coronary Patients

H. Cem Alhan, MD, Hasan Karabulut, MD, Remzi Tosun, MD, Fehime Karakoç, MD, mer Okar, MD, Erdoan Demiray, MD, Sümer Tarcan, MD, Besim Yiiter, MD

Siyami Ersek Thoracic and Cardiovascular Surgery Center and Department of Histology and Embryology, University of Marmara, Istanbul, Turkey

Accepted for publication November 2, 1995.

Background. Blood cardioplegic strategies have been shown to increase myocardial oxygen uptake, replenish depleted energy stores, and improve myocardial function and survival in the high-risk subset of patients. However, the superiority of these techniques over intermittent aortic cross-clamping and crystalloid cardioplegia in low-risk patients is still controversial.

Methods. This study consisted of two parts. In the first part, we assessed the results of a recent cohort of 399 consecutive low-risk patients undergoing their first coronary artery bypass grafting between 1993 and 1995 using cold crystalloid cardioplegia (n = 128) and intermittent aortic cross-clamping (n = 271). In the second part of the study, 40 consecutive low-risk patients undergoing elective first-time coronary artery bypass grafting were randomly divided into two equal groups. One group received cold crystalloid cardioplegia and the other group had myocardial management with intermittent aortic cross-clamping. The two groups were compared with respect to hemodynamic, biochemical, and ultrastructural changes.

Results. The overall mortality rate, the perioperative myocardial infarction rate, the need for intraaortic balloon pumps, and the need for inotropic agents were 0.25%, 1.5%, 1%, and 5.8%, respectively. No significant differences were observed between the groups with respect to these clinically defined end points.

Conclusions. Both intermittent aortic cross-clamping and cold crystalloid cardioplegia techniques may be used safely in low-risk patients undergoing first-time coronary artery bypass grafting.

This article has been cited by other articles:

				M. Scarci, H. B. Fallouh, C. P. Young, and D. J. Chambers Does intermittent cross-clamp fibrillation provide equivalent myocardial protection compared to cardioplegia in patients undergoing bypass graft revascularisation? Interactive CardioVascular and Thoracic Surgery, November 1, 2009; 9(5): 872 - 878. [Abstract] [Full Text] [PDF]

				V. Venugopal, A. Ludman, D. M. Yellon, and D. J. Hausenloy 'Conditioning' the heart during surgery Eur. J. Cardiothorac. Surg., June 1, 2009; 35(6): 977 - 987. [Abstract] [Full Text] [PDF]

				J. Dunning, J. R.L. Waller, B. Smith, S. Pitts, S. W.H. Kendall, and K. Khan Coronary Artery Bypass Grafting is Associated With Excellent Long-Term Survival and Quality of Life: A Prospective Cohort Study Ann. Thorac. Surg., June 1, 2008; 85(6): 1988 - 1993. [Abstract] [Full Text] [PDF]

				P. K. Mishra Fibrillatory arrest technique: is it worth tasting the old wine in new bottle? Eur. J. Cardiothorac. Surg., May 1, 2006; 29(5): 860 - 860. [Full Text] [PDF]

				M. Fujii, M. Avkiran, and D. J Chambers Experimental studies on myocardial protection with intermittent cross-clamp fibrillation: additive effect of the sodium-hydrogen exchanger inhibitor, cariporide Ann. Thorac. Surg., April 1, 2004; 77(4): 1398 - 1407. [Abstract] [Full Text] [PDF]

				J. Alex, V. P. Rao, A. R.J. Cale, S. C. Griffin, M. E. Cowen, and L. Guvendik Surgical nurse assistants in cardiac surgery: a UK trainee's perspective Eur. J. Cardiothorac. Surg., January 1, 2004; 25(1): 111 - 115. [Abstract] [Full Text] [PDF]

				L. Raco, E. Mills, and R. J.W. Millner Isolated myocardial revascularization with intermittent aortic cross-clamping: experience with 800 cases Ann. Thorac. Surg., May 1, 2002; 73(5): 1436 - 1439. [Abstract] [Full Text] [PDF]

				U. Sunderdiek, P. Feindt, and E. Gams Aortocoronary bypass grafting: a comparison of HTK cardioplegia vs. intermittent aortic cross-clamping Eur. J. Cardiothorac. Surg., October 1, 2000; 18(4): 393 - 399. [Abstract] [Full Text] [PDF]

				R. Bessho and D. J. Chambers Experimental study of intermittent crossclamping with fibrillation and myocardial protection: Reduced injury from shorter cumulative ischemia or intrinsic protective effect? J. Thorac. Cardiovasc. Surg., September 1, 2000; 120(3): 528 - 537. [Abstract] [Full Text] [PDF]

				A. Borowski, M.R. Raji, H.C. Eichstaedt, S. Schickendantz, and H. Korb Myocardial protection by pressure- and volume-controlled continuous hypothermic coronary perfusion in combination with Esmolol and nitroglycerine for correction of congenital heart defects in pediatric risk patients Eur. J. Cardiothorac. Surg., September 1, 1999; 14(3): 243 - 249. [Abstract] [Full Text] [PDF]

				A. S. Koppula, B. R. Jagannath, K. R. Balakrishnan, and C. M. Gupta Noncardioplegic Myocardial Protection for CABG Deserves a Second Look Ann. Thorac. Surg., March 1, 1997; 63(3): 914 - 915. [Full Text]