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Ann Thorac Surg 1987;43:17-24
© 1987 The Society of Thoracic Surgeons

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Articles

Right Ventricular Function: A Comparison Between Blood and Crystalloid Cardioplegia

From the Divisions of Cardiovascular Surgery and Nuclear Cardiology, the Toronto General Hospital and the University of Toronto, Toronto, Ont, Canada

^* Address reprint requests to Dr. Weisel, Cardiovascular Surgery, Toronto General Hospital, 200 Elizabeth St, Eaton North 13–224, Toronto, Ont, Canada M5G 2C4

	Abstract

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Blood cardioplegia resulted in better left ventricular (LV) function than crystalloid cardioplegia after elective coronary artery bypass operations, However, most methods of cardioplegic delivery may not adequately cool and protect the right ventricle, and right ventricular (RV) dysfunction may limit hemodynamic recovery. Therefore, RV and LV temperatures were measured intraoperatively and RV and LV function were evaluated postoperatively in 80 patients with double-vessel or triple-vessel coronary artery disease who were randomized to receive either blood cardioplegia or crystalloid cardioplegia. Myocardial performance, systolic function, and diastolic function were assessed with nuclear ventriculography by evaluating the response to volume loading. Preoperatively the groups were similar. Intraoperatively, blood cardioplegia resulted in significantly warmer LV and RV temperatures (left ventricle: 15.5° ± 0.2°C with blood cardioplegia and 12.6° ± 0.3°C with crystalloid cardioplegia [p < .0001]; right ventricle: 18.3° ± 0.3°C with blood cardioplegia and 15.1° ± 0.3°C with crystalloid cardioplegia [p < .0001]). Postoperatively, blood cardioplegia resulted in better LV performance (higher LV stroke work index at a similar LV end-diastolic volume index [EDVI]) (p = .01), better LV systolic function (similar systolic blood pressures at smaller LV end-systolic volume indexes [EDVI]), (p = .04), and improved LV diastolic function (lower left atrial pressures at similar LVEDVIs) (p = .03). For the right ventricle, performance and diastolic function were similar after blood and crystalloid cardioplegia, but RV systolic function was better (p = .03) with crystalloid cardioplegia (systolic pulmonary artery pressures were higher, 29.8 ± 1.8 mm Hg with crystalloid cardioplegia and 25.0 ± 0.8 mm Hg with blood cardioplegia at similar RVESVIs, 62 ± 4 mL/m² for crystalloid cardioplegia and 60 ± 6 ml/m² with blood cardioplegia).

Blood cardioplegia provided excellent protection for the left ventricle but crystalloid cardioplegia produced colder RV temperatures and better postoperative RV function.

	Footnotes

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Presented at the Twenty-second Annual Meeting of The Society of Thoracic Surgeons, Washington, DC, Jan 27–29, 1986.

	References

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This Article Abstract Full Text (PDF) 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 Mullen, J. C. Articles by McLaughlin, P. R. Search for Related Content PubMed PubMed Citation Articles by Mullen, J. C. Articles by McLaughlin, P. R.