Blood cardioplegia with warm reperfusion versus intermittent aortic crossclamping in myocardial revascularization. Randomized controlled trial

J Thorac Cardiovasc Surg. 1993 Sep;106(3):491-6.

Abstract

To compare the efficiency of two methods of myocardial protection--blood cardioplegia and warm reperfusion with aspartate-glutamate enrichment of the solution versus intermittent aortic crossclamping--we randomized 60 patients for coronary artery bypass grafting. Hemodynamic parameters and hospital mortality were the end points. Pathologic antecedents and preoperative clinical conditions were similar in both group I (blood cardioplegia, 30 patients) and group II (aortic crossclamping, 30 patients). An average of 2.9 grafts per patient were performed in group I and 3.1 in group II. Duration of extracorporeal circulation was 100 +/- 28 minutes in group I and 85 +/- 23 minutes in group II (p < 0.05). The total time of aortic crossclamping was 62.8 +/- 24.5 minutes in group I and 44.3 +/- 14.9 minutes in group II (p < 0.05). There were comparable increases in cardiac index in group I and group II from the preoperative period to the first postoperative day, but none of these changes reached statistical significance. There were two deaths, one in the cardioplegia group (3.3%) and another in the intermittent aortic crossclamping group (3.3%). In conclusion, in myocardial revascularization, intermittent aortic crossclamping and blood cardioplegia with warm reperfusion enriched with aspartate-glutamate solution are methods of similar efficiency.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aorta
  • Aspartic Acid
  • Blood
  • Cardioplegic Solutions
  • Constriction
  • Coronary Artery Bypass*
  • Creatine Kinase / blood
  • Female
  • Glutamates
  • Glutamic Acid
  • Heart Arrest, Induced* / methods
  • Hemodynamics
  • Humans
  • Isoenzymes
  • Male
  • Middle Aged
  • Myocardial Reperfusion* / methods
  • Postoperative Complications
  • Temperature

Substances

  • Cardioplegic Solutions
  • Glutamates
  • Isoenzymes
  • Aspartic Acid
  • Glutamic Acid
  • Creatine Kinase