ISSN : 2146-3123
E-ISSN : 2146-3131

Myocardial Protection with Simultaneous Antegrade/Vein Graft Cardioplegia Compared to Antegrade Cardioplegia Alone in Elective Coronary Artery Bypass Grafting Patients
Ali Can Hatemi 1, Mete Gürsoy 1, Aybala Tongut 1, Mustafa Canikoğlu 1, Erhan Kansız 1, Rıfat Eralp Ulusoy 2, Ayşem Kaya 3, Nadiye Pınar Ay 4, Rasim Enar 5, Fatma Ferda Sözer 6, Kamil Karaoğlu 6
1 Department of Cardiovascular Surgery, Institute of Cardiology, İstanbul University, İstanbul, Turkey
2Department of Cardiology, Gülhane Military Medical Academy Haydarpasa Training Hospital, İstanbul, Turkey
3Department of Biochemistry Laboratory, Institute of Cardiology, İstanbul University, İstanbul, Turkey
4Department of Public Health, Faculty of Medicine, Marmara University, İstanbul, Turkey
5Department of Cardiology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey
6Department of Anesthesiology and Reanimation, Institute of Cardiology, İstanbul University, İstanbul, Turkey
DOI : 10.5174/tutfd.2009.03129.1
Pages : 75-79


Objective: Cardioplegia distribution beyond a stenotic coronary artery may not be adequate. This problem can be overcome by direct delivery of cardioplegia via the vein grafts anastomosed during the operation. The aim of this study is to investigate the results of simultaneous antegrade/vein graft cardioplegia versus antegrade cardioplegia alone in elective CABG patients.

Material and Methods: Forty consecutive patients were randomized into the study group to whom antegrade/vein cardioplegia and to the control group to whom only antegrade cardioplegia was given. Both groups were similar with respect to demographic characteristics, postoperative ECG changes and arrhythmia in the ICU, as well as in terms of operative and postoperative variables (p>0.05).

Results: All patients had excellent operative and postoperative periods without any complications or death. Release of total CK, CKMB, cTnI and lactate did not differ in the preoperative and the first 12th hour (p>0.05) between the groups, whereas in the study group a peak for total CK, CKMB, cTnI and lactate, consistent with myocardial injury (p<0.05), was found in the first 24th hour, which returned in the 48th hour (p>0.05).

Conclusion: The primary finding of this study is the inferiority of myocardial protection with simultaneous antegrade/vein graft cardioplegia compared with antegrade cardioplegia alone.

Keywords : Coronary artery bypass surgery, myocardial protection, cardioplegia, vein graft, reperfusion injury
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