Comparative Sludy Between Cold Retrograde Blood and ..... Antegrade Crvstalloid Cardioplegia in Myocardial Protection .•

Abstract

The use of retrograde coronary sinus cardioplegic perfusion has been proposed as an alternative method of providing myocardial protection. Our study is designed to assess and compare the use of retrograde cold blood cardioplegia versus antegrade crystalloid cardioplegia.

Sixty patients undergoing myocardial revascularization were prospectively randomized into two groups. Group I included 30 patients received intermittent antegrade cold (4 0C) crystalloid cardioplegia through the aortic root and group II included 30 patients received intermittent retrograde cold (18 °C) blood cardioplegia with warm induction and• reperfusion. The myocardial temperature was kept at 10-12 °C in group I and at 18-20 °C in group II.

There was no hospital death in the two groups (within 30 days). However, 2 patients of PMI have been encountered in group I. Hospital morbidity other than PMI, did not differ significantly between the two group. No significant differences were observed between the 2 groups with respect to age, sex, angina class, preoperative EF%, risk factors for coronary disease, medications, or number of diseases vessels.

CPB and cross clamping time as well as total number of distal anastomosis were similar in both groups. However, more arterial grafts have been done in group II. Also, K+ level and Ht valve measured at the weaning of bypass were similar. The incidence of spontaneous defibrillation was higher in group II than in group I (27/30, 90% versus 14/30, 46.6%). The need for inotropic support at the end of operation was more frequent in group I (than in group II) (14/30, 46.6% versus 4/30, 13.3%).