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The Annals of Thoracic Surgery, Vol 56, 1315-1323, Copyright © 1993 by The Society of Thoracic Surgeons

ARTICLES

Myocardial function in early hours after coronary artery bypass grafting: comparison of two cardioplegic methods

B Biagioli, P Giomarelli, G Gnudi, E Artioli, F Simeone, G Paolini, L Marchetti and A Grossi
Istituto di Chirurgia Toracica e Cardiovascolare, University of Siena, Italy.

The theoretical advantages of retrograde blood cardioplegia combined with anterograde blood cardioplegia and warm reperfusion before aortic unclamping during coronary surgery were evaluated in 41 patients (group 2). The early postoperative myocardial function of this group was compared with that of 55 patients (group 1) in whom cold crystalloid cardioplegia was administered. The following variables were measured and analyzed by multivariate statistical analysis: heart rate, left atrial pressure, systemic arterial pressure, cardiac index, left ventricular stroke work index, ventricular function, oxygen delivery, hemoglobin, partial oxygen pressure in mixed venous blood, arteriovenous oxygen difference, carbon dioxide production per square meter, and cardiac isoenzyme of creatine-kinase. The myocardial function improved progressively and cardiac enzymatic release was low for both groups 9 hours after admission to the intensive care unit. However, group 2 had significantly higher oxygen delivery, carbon dioxide production per square meter, cardiac index, left ventricular stroke work index, and ventricular function and significantly lower left atrial pressure and mean systemic arterial pressure than that of group 1. The best separation of group 2 from group 1 occurred at the ninth hour, with a probability of correct recognition of 92.1%.

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