• J Ehrenberg, M Intonti, A Owall, L A Brodin, T Ivert, and D Lindblom.
• Department of Cardiothoracic Surgery and Anaesthesiology, Huddinge Hospital, Sweden.
• J. Cardiothorac. Vasc. Anesth. 2000 Aug 1; 14 (4): 383-7.

ObjectiveTo investigate retrograde and antegrade crystalloid cardioplegia in terms of cardiac cooling and postoperative cardiac function.DesignProspective, randomized, and blinded.SettingUniversity hospital.ParticipantsTwenty male patients with triple-vessel disease and proximal occlusion of the circumflex or the left anterior descending coronary artery.InterventionsLeft ventricular ejection fraction at rest and during exercise was evaluated by nuclear ventriculography the day before and 3 months after surgery. After induction of anesthesia and hourly for the first 5 postoperative hours, hemodynamic, echocardiographic, and electrocardiographic data were acquired. Myocardial temperature was measured with needle thermistors in 3 myocardial regions.Measurements And Main ResultsDemographic and temperature data were analyzed by t-test. Hemodynamic and echocardiographic data were analyzed by analysis of variance. The groups were similar in baseline characteristics. Retrograde cardioplegia cooled the region distal to an occlusion better than antegrade cardioplegia (9.6 degrees C +/- 4.8 degrees C v 21.8 degrees C +/- 5.9 degrees C; p < 0.01). Hemodynamic, echocardiographic, and electrocardiographic data did not differ between the groups. Three months after surgery, the retrograde cardioplegia group showed a higher left ventricular ejection fraction at rest (58% +/- 10% v 47% +/- 10%; p < 0.02) and during exercise (58% +/- 13% v 47% +/- 10%; p < 0.05) compared with the antegrade cardioplegia group.ConclusionsRetrograde cardioplegia provides more homogenous myocardial cooling than antegrade cardioplegia in hearts with coronary artery occlusions. The use of retrograde cardioplegia seems to benefit long-term left ventricular function.

18 keywords...

hide…