| Autor: |
Laughlin, Lawrence, Bailey, Leonard, Willis, William, Gaskill, William, Jacobson, John, Rasi, Alfredo, Wareham, Ellsworth |
| Zdroj: |
Journal of Thoracic and Cardiovascular Surgery; August 1980, Vol. 80 Issue: 2 p289-292, 4p |
| Abstrakt: |
A prospective series of 100 patients undergoing coronary artery bypass was divided into two groups for analysis of myocardial preservation by topical hypothermia with and without cold cardioplegia. The aorta was irrigated with a single bolus (750 cc) of cold cardioplegic solution in the study group. In addition, local hypothermia was achieved with cold topical saline. Local hypothermia alone was employed in the control group. Core cooling to 28° C was utilized for both groups. Fifty-two patients returned for late follow-up evaluation including biplane left ventriculography and coronary arteriography. Five had perioperative myocardial infarction and were eliminated from the study. Comparison of postoperative with preoperative ejection fraction (EF) in the remaining 47 showed no significant change in the study group. There was some decrease of the EF in the control group but the change was not highly significant (p = 0.083). Comparison of the change of the EF between the two groups was not statistically significant. There was no significant difference in the pre- and postoperative levels of serum glutamic oxaloacetic transaminase (SGOT) or creatinine phosphokinase (CPK), and electrocardiograms failed to demonstrate superiority of either preservation technique. The serum lactic dehydrogenase (LDH) enzymes were significantly lower in the study group on postoperative days 1, 2, and 3 (p = 0.01). Failure to demonstrate a definite advantage for use of cold cardioplegia may have derived from the method of application, which consisted of a single bolus of solution. We believe that assessment of any method of cardioplegia should include an objective index of myocardial performance such as EF measured by identical techniques before and after operation. |
| Databáze: |
Supplemental Index |
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