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Hitoshi Okabayashi
Ichiro Shimada
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Ann Thorac Surg 2000;69:74-76
© 2000 The Society of Thoracic Surgeons

Original Articles

Intermittent antegrade warm blood cardioplegia for CABG: extended interval of cardioplegia

Kenji Minatoya, MDa, Hitoshi Okabayashi, MD, PhDa, Ichiro Shimada, MDa, Atsushi Tanabe, MDa, Takeshi Nishina, MDa, Koichiro Nandate, MDa, Mitsuru Kunihiro, MDa

a Divisions of Cardiovascular Surgery and Anesthesiology, Kokura Memorial Hospital, Fukuoka, Japan

Address reprint requests to Dr Minatoya, Department of Cardiovascular Surgery, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-0873, Japan
e-mail: harbour{at}hsp.ncvc.go.jp

Background. Intermittent delivery of warm cardioplegia provides a bloodless surgical field, but it is clinically important to evaluate the periods of normothermic ischemia. The aims of this study are to compare intermittent antegrade warm blood cardioplegia (IAWBC) with intermittent antegrade cold blood cardioplegia (IACBC) groups in terms of myocardial protection, and also to evaluate whether the length of ischemic time in the IAWBC group has an effect on myocardial dysfunction.

Methods. This study is based on a retrospective review of patients who underwent elective coronary artery bypass surgery: 162 consecutive patients with IAWBC and 107 consecutive patients with IACBC.

Results. The creatinine kinase peak was smaller in the IAWBC group compared with the IACBC group (p < 0.0001). The cardiac index after cardiopulmonary bypass was higher in the IAWBC group (p < 0.02), and the amount of inotropic support required to wean from cardiopulmonary bypass was less in the IAWBC group compared with the IACBC group (p < 0.0001).

Conclusions. IAWBC with 30 minutes of ischemia provides to be clinically acceptable myocardial protection for coronary bypass surgery.




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