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ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 2000 Febbraio;41(1):11-6

CARDIAC PAPERS 

 ORIGINAL ARTICLES

Comparison of retrograde vs simultaneous ante/retrograde cold blood cardioplegia

Jasinski M. *, Wos S., Kadziola Z., Wenzel-Jasinska I., Spyt T. J. *

From the 2nd Depart­ment of Car­diac Sur­gery Sile­sian Med­ical ­Academy, ­Katowice, ­Poland
and the *Department of Car­di­oth­o­racic Sur­gery Glen­field Hos­pital, Lei­cester, UK

Back­ground. To eval­uate the homeo­stasis of myo­car­dium ­during simul­ta­neous con­tin­uous ret­ro­grade and ante­grade car­di­o­plegia vs ret­ro­grade con­tin­uous car­di­o­plegia.
­Methods. 40 ­patients who under­went elec­tive oper­a­tion of cor­o­nary ­arteries ­bypass ­grafting ­were ran­domly ­assigned to 2 ­groups: ­group one con­sisted of 24 ­patients who ­received ret­ro­grade con­tin­uous ­blood car­di­o­plegia; ­group two con­sisted of 16 ­patients who ­received simul­ta­neous con­tin­uous ­ante/ret­ro­grade car­di­o­plegia. The fol­lowing meas­ure­ments ­were ­taken: aci­dosis, ­oxygen con­tent, ­oxygen extrac­tion and ­oxygen con­sump­tion; ­they ­were ­taken ­before and ­after ­cross-­clamp ­releasing ­from cor­o­nary ­sinus ­effluent and ­from arte­rial ­line. Inci­dence of low car­diac ­output, ven­tric­ular fib­ril­la­tion, ­raised car­diac ­enzymes and ­ischemic ­changes on ECG was ­noted.
­Results. In simul­ta­neous ­group ­such param­e­ters as aci­dosis, ­oxygen con­tent, ­oxygen extrac­tion and myo­car­dial ­oxygen con­sump­tion recov­ered ­after ­cross-­clamping and ­changes of ­their ­values ­were respec­tively: 0.0005, 0.87 ml/100 ml, 0.098 and 1.4 ml/min. The ­same param­e­ters ­didn’t recov­ered in ret­ro­grade ­group and ­changes ­were respec­tively: 0.05 - p=0.2; 3.7 ml/100 ml - p=0.006, 0.29 p=0.006 and 7.4 ml/min - p=0.03. ­These ­changes ­were sig­nif­i­cant ­between ­groups.
Con­clu­sions. Meta­bolic ­viability of myo­car­dium meas­ured ­with ­oxygen util­isa­tion is ­better pre­served ­with simul­ta­neous ante­grade and ret­ro­grade car­di­o­plegia.

lingua: Inglese


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