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Cold crystalloid versus warm blood cardioplegia for coronary artery bypass surgery.
Ann Thorac Cardiovasc Surg. 2005 Dec; 11(6):382-5.AT

Abstract

PURPOSE

Intermittent cold crystalloid cardioplegia by antegrade route to arrest the heart for coronary artery bypass grafting (CABG) is a commonly used technique. The aim of this study is to compare the intermittent antegrade warm blood cardioplegia with cold crystalloid cardioplegia by means of measuring myocardial injury markers CKMB and troponin T. We also compared the results with antegrade and retrograde warm blood cardioplegia.

MATERIALS AND METHODS

Patients (n=30) undergoing CABG were prospectively randomized into group 1 (n=10) which received cold crystalloid cardioplegia by antegrade route, group 2 (n=10) which received warm blood cardioplegia by antegrade route and group 3 (n=10) which received antegrade/retrograde warm blood cardioplegia.

RESULTS

Preoperative and intraoperative variables were equal in all three groups. Control levels of troponin T and CKMB were in a normal range. Postoperative troponin T was significantly lower in group 3 compared to group 2 (p"=0.008") and to group 1 (p"=0.005"). CKMB is significantly higher in group 1 compared to group 2 (p"=0.013") and higher in group 2 than that in group 3 (p"=0.043").

CONCLUSION

Antegrade with retrograde warm blood cardioplegia is a simple delivery method. Troponin T and CKMB levels were significantly lower, suggesting that this offered better myocardial protection than antegrade cold crystalloid and warm blood cardioplegia. We recommend its wider use.

Authors+Show Affiliations

Department of Cardiothoracic Surgery, Liaquat National Hospital, Karachi, Pakistan.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16401986

Citation

Dar, Mudassir Iqbal. "Cold Crystalloid Versus Warm Blood Cardioplegia for Coronary Artery Bypass Surgery." Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia, vol. 11, no. 6, 2005, pp. 382-5.
Dar MI. Cold crystalloid versus warm blood cardioplegia for coronary artery bypass surgery. Ann Thorac Cardiovasc Surg. 2005;11(6):382-5.
Dar, M. I. (2005). Cold crystalloid versus warm blood cardioplegia for coronary artery bypass surgery. Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia, 11(6), 382-5.
Dar MI. Cold Crystalloid Versus Warm Blood Cardioplegia for Coronary Artery Bypass Surgery. Ann Thorac Cardiovasc Surg. 2005;11(6):382-5. PubMed PMID: 16401986.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cold crystalloid versus warm blood cardioplegia for coronary artery bypass surgery. A1 - Dar,Mudassir Iqbal, PY - 2006/1/13/pubmed PY - 2006/5/6/medline PY - 2006/1/13/entrez SP - 382 EP - 5 JF - Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia JO - Ann Thorac Cardiovasc Surg VL - 11 IS - 6 N2 - PURPOSE: Intermittent cold crystalloid cardioplegia by antegrade route to arrest the heart for coronary artery bypass grafting (CABG) is a commonly used technique. The aim of this study is to compare the intermittent antegrade warm blood cardioplegia with cold crystalloid cardioplegia by means of measuring myocardial injury markers CKMB and troponin T. We also compared the results with antegrade and retrograde warm blood cardioplegia. MATERIALS AND METHODS: Patients (n=30) undergoing CABG were prospectively randomized into group 1 (n=10) which received cold crystalloid cardioplegia by antegrade route, group 2 (n=10) which received warm blood cardioplegia by antegrade route and group 3 (n=10) which received antegrade/retrograde warm blood cardioplegia. RESULTS: Preoperative and intraoperative variables were equal in all three groups. Control levels of troponin T and CKMB were in a normal range. Postoperative troponin T was significantly lower in group 3 compared to group 2 (p"=0.008") and to group 1 (p"=0.005"). CKMB is significantly higher in group 1 compared to group 2 (p"=0.013") and higher in group 2 than that in group 3 (p"=0.043"). CONCLUSION: Antegrade with retrograde warm blood cardioplegia is a simple delivery method. Troponin T and CKMB levels were significantly lower, suggesting that this offered better myocardial protection than antegrade cold crystalloid and warm blood cardioplegia. We recommend its wider use. SN - 1341-1098 UR - https://www.unboundmedicine.com/medline/citation/16401986/Cold_crystalloid_versus_warm_blood_cardioplegia_for_coronary_artery_bypass_surgery_ L2 - https://medlineplus.gov/coronaryarterybypasssurgery.html DB - PRIME DP - Unbound Medicine ER -