• Pol. Merkur. Lekarski · May 2006

    Randomized Controlled Trial

    [Antegrade warm blood cardioplegia versus cold blood cardioplegia in normothermia in the coronary artery bypass grafting procedures. Troponine I release as a marker of periopertive myocardial ischemia].

    • Janusz Skarysz, Michał Krejca, Przemysław Szmagała, Rafał Ulczok, and Andrzej Bochenek.
    • Slaska Akademia Medyczna w Katowicach, I Klinika Kardiochirurgii.
    • Pol. Merkur. Lekarski. 2006 May 1;20(119):539-42.

    UnlabelledWarm myocardial protection has had a strong impact on modern cardiac surgery. The O2 consumption of a heart, arrested by potassium-enriched normothermic blood is 90% less than baseline values. Hypothermia gives only a slight reduction in oxygene consumption.The Aim Of This Studywas to test the quality of myocardial protection provided by intermittent antegrade warm blood cardioplegia (IAWBC) by comparing it with cold blood cardioplegia.Material And MethodsWe designed a prospective randomized study by using 2 different temperatures of blood cardioplegia: warm, from 35 degrees C to 37 degrees C (group I--36 men and 14 women, mean age 56 +/- 7); and cold, from 6 degrees C to 8 degrees C (group II--40 men and 10 women, mean age 58 +/- 9). Cardiac troponin I release was the criterion used to evaluate the adequacy of myocardial protection,ResultsThe heartbeat in 92% of patients treated with warm cardioplegia converted to normal sinus rhythm spontaneously after removal of the aortic crossclamp compared with only 18% of the cold cardioplegia group. Cardiac troponin I concentration was significantly higher in the cold group. Our study demonstrates a significant reduction of myocardial cell damage with the use of IAWBC.ConclusionOur clinical results have shown that IAWBC is a superior method compared to intermittent cold cardioplegia.

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