BibTex RIS Kaynak Göster

A COMPARISON OF CRYSTALLOID AND BLOOD INDUCTION CARDIOPLEGIA IN LOW - RISK PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING

Yıl 2002, Cilt: 15 Sayı: 1, 39 - 43, 03.12.2016

Öz

Objective: Improvements in the application of cardio protective methods in open-heart surgery have been associated with decreased operative mortality, lowered incidence of perioperative myocardial infarction and improved cardiac functions.
Material and Methods: One hundred
consecutive patients undergoing their first elective coronary artery bypass grafting were prospectively randomized to receive either cold crystalloid cardioplegia (Group A, n: 50) or cold blood cardioplegia (Group B, n: 50). Patients in group A received initial cold crystalloid cardioplegia, patients in group B received initial cold blood cardioplegia that was a mixture (4:1) of the oxygenated blood of the patient and hyperkalemic crystalloid concentration. In both groups, following the inital cardioplegia, cold blood cardioplegia every 20 minutes and finally warm blood cardioplegia (37°C) was performed before the removal of the aortic cross clamp.
Results: In both groups, the baseline patient characteristics did not differ. During the cardiopulmonary bypass, blood transfusion was applied to the bypass circuit 11 patients in group A and 2 patients in group B because of low hemoglobin level (p<0.001). Following removal of
the aortic cross clamp, the incidence of spontaneous defibrillation in group A was lower than in group B (p<0.001). Creatin kinase isoenzyme MB level at the 12th hour postoperatively was significantly higher in group A than in group B (p<0.01). Perioperative Ml was in three patients in group A and 1 patient in group B, (p: not significant). The incidence of atrial fibrillation, ventricular extrasystole and low cardiac out-put was similar in both groups.
Conclusion: Cold blood induction performs better myocardial protection and faster myocardial recovery than the cold crystalloid induction cardioplegia in low-risk patients undergoing coronary artery bypass grafting.
Key Words: Cardioplegia, Antegrade,
Protection, CABG

Kaynakça

  • Chitwood WK, Hill RC, Kleinman LH, Wechsler AS. Transmural myocardial How distribution during hypothermia. Effects of coronary inflow restriction. J Thorac Cardiovasc Surg 1983; 86: 61-69.
  • Becker H, Vinten-Johansen J, Buckberg GD, et al. Critical importance of ensuring cardioplegic delivery with coronary stenosis. J Thorac Cardiovasc Surg 1981: 81: 507-515
  • Weisel RD, Hoy EBY, Baird RJ, et al. Comparison of alternative cardioplegic techniques. J Thorac Cardiovasc Surg 1983; 86: 97-107
  • Weisel RD Hoy EBY, Baird RJ, et al. Improved myocardial protection during a prolonged cross-clamp period. Ann Thorac Surg 1983; 36: 664-674
  • Elack JE, Cook JR, May SJ, et al. Does cardioplegia type affect outcome and survival in patients with advanced left ventricular dysfunction? Circulation 2000; 7:111-84-89
  • Roberts AJ, Moran JM, Sanders JH, et al. Clinical evaluation of the relative effectiveness of multidose crystalloid and cold blood potassium cardioplegia in coronary artery bypass graft surgery. A nonrandomized match-pair analysis. Ann Thorac Surg 1982; 33: 421-432
  • Stephen EE, Christakis GT, Weisel RT, et al. A clinical trial of blood and crystalloid
  • cardioplegia. J Thorac Cardiovasc Surg 1984; 88: 726-741
  • Brat R, Tosovsky J, Januska J, et al. Comparison between blood and crystalloid cardioplegia in patients with left ventricular dysfunction undergoing coronary surgery. Acta Medica 2000; 43: 107-110
  • Hendry PJ, Masters RG, Haspect A. Is there a place for cold crystalloid cardioplegia in the 1990s? Ann Thorac Surg 1994; 58: 1690- 1694
  • Gerola LR, Oliveira S/t, Moreira LEP, et al Blood cardioplegia with warm reperfusion versus intermittent aortic cross-clamping in myocardial revascularization. J Thorac Cardiovasc Surg 1993; 106: 491-496
  • Loop ED, Higgins TL, Panda R, et al. Myocardial protection during cardiac operations. J Thorac Cardiovasc Surg 1992; 104: 608-618
  • Caputo M, Dihmis W, Birdi T, et al. Cardiac troponin T and troponin I release during coronary artery surgery using cold crystalloid and cold blood cardioplegia. Eur J Cardiothorac Surg 1997 Aug: 12: 254-260
  • Gundry SR, Sequeira A, Coughlin TR, McLaughlin JS. Postoperative conduction disturbances: a comparison of blood and crystalloid cardioplegia. Ann Thorac Surg 1989 Mar; 47: 384-390
  • Demmy TL, Haggerty SP, Boley TM, et al. Lack of cardioplegia uniformity in clinical myocardial preservation. Ann Thorac Surg 1994; 57: 648-651
  • Robinson LA, Schwarz GD, Goddard DB, et al. Myocardial protection for acquired heart disease surgery: results of a national survey. Ann Thorac Surg 1995; 59: 361-372
  • Rosenkranz ER, Okamoto F, Buckberg GD, et al. Safety of prolonged aortic clamping with blood cardioplegia III. Aspartate enrichment of glutamate-blood cardioplegia in energy depleted hearts after ischemic and reperfusion injury. J Thorac Cardiovacs Surg 1986; 91: 428-435
  • Pichon H, Chocron S, Alwan K, et al. Crystalloid versus cold blood cardioplegia and cardiac troponin / release. Circulation 1997 Jul I; 96: 316-320
  • Michael C, Manuey MC, Rron IL. The physiologic basis of warm cardioplegia. Ann Thorac Surg 1995; 60: 819-823
  • Lichtenstein SU, Ashe RA, El Dalati H, et al. Warm heart surgery. J Thorac Cardiovasc Surg 1991; 101: 269-274
Yıl 2002, Cilt: 15 Sayı: 1, 39 - 43, 03.12.2016

Öz

Kaynakça

  • Chitwood WK, Hill RC, Kleinman LH, Wechsler AS. Transmural myocardial How distribution during hypothermia. Effects of coronary inflow restriction. J Thorac Cardiovasc Surg 1983; 86: 61-69.
  • Becker H, Vinten-Johansen J, Buckberg GD, et al. Critical importance of ensuring cardioplegic delivery with coronary stenosis. J Thorac Cardiovasc Surg 1981: 81: 507-515
  • Weisel RD, Hoy EBY, Baird RJ, et al. Comparison of alternative cardioplegic techniques. J Thorac Cardiovasc Surg 1983; 86: 97-107
  • Weisel RD Hoy EBY, Baird RJ, et al. Improved myocardial protection during a prolonged cross-clamp period. Ann Thorac Surg 1983; 36: 664-674
  • Elack JE, Cook JR, May SJ, et al. Does cardioplegia type affect outcome and survival in patients with advanced left ventricular dysfunction? Circulation 2000; 7:111-84-89
  • Roberts AJ, Moran JM, Sanders JH, et al. Clinical evaluation of the relative effectiveness of multidose crystalloid and cold blood potassium cardioplegia in coronary artery bypass graft surgery. A nonrandomized match-pair analysis. Ann Thorac Surg 1982; 33: 421-432
  • Stephen EE, Christakis GT, Weisel RT, et al. A clinical trial of blood and crystalloid
  • cardioplegia. J Thorac Cardiovasc Surg 1984; 88: 726-741
  • Brat R, Tosovsky J, Januska J, et al. Comparison between blood and crystalloid cardioplegia in patients with left ventricular dysfunction undergoing coronary surgery. Acta Medica 2000; 43: 107-110
  • Hendry PJ, Masters RG, Haspect A. Is there a place for cold crystalloid cardioplegia in the 1990s? Ann Thorac Surg 1994; 58: 1690- 1694
  • Gerola LR, Oliveira S/t, Moreira LEP, et al Blood cardioplegia with warm reperfusion versus intermittent aortic cross-clamping in myocardial revascularization. J Thorac Cardiovasc Surg 1993; 106: 491-496
  • Loop ED, Higgins TL, Panda R, et al. Myocardial protection during cardiac operations. J Thorac Cardiovasc Surg 1992; 104: 608-618
  • Caputo M, Dihmis W, Birdi T, et al. Cardiac troponin T and troponin I release during coronary artery surgery using cold crystalloid and cold blood cardioplegia. Eur J Cardiothorac Surg 1997 Aug: 12: 254-260
  • Gundry SR, Sequeira A, Coughlin TR, McLaughlin JS. Postoperative conduction disturbances: a comparison of blood and crystalloid cardioplegia. Ann Thorac Surg 1989 Mar; 47: 384-390
  • Demmy TL, Haggerty SP, Boley TM, et al. Lack of cardioplegia uniformity in clinical myocardial preservation. Ann Thorac Surg 1994; 57: 648-651
  • Robinson LA, Schwarz GD, Goddard DB, et al. Myocardial protection for acquired heart disease surgery: results of a national survey. Ann Thorac Surg 1995; 59: 361-372
  • Rosenkranz ER, Okamoto F, Buckberg GD, et al. Safety of prolonged aortic clamping with blood cardioplegia III. Aspartate enrichment of glutamate-blood cardioplegia in energy depleted hearts after ischemic and reperfusion injury. J Thorac Cardiovacs Surg 1986; 91: 428-435
  • Pichon H, Chocron S, Alwan K, et al. Crystalloid versus cold blood cardioplegia and cardiac troponin / release. Circulation 1997 Jul I; 96: 316-320
  • Michael C, Manuey MC, Rron IL. The physiologic basis of warm cardioplegia. Ann Thorac Surg 1995; 60: 819-823
  • Lichtenstein SU, Ashe RA, El Dalati H, et al. Warm heart surgery. J Thorac Cardiovasc Surg 1991; 101: 269-274
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Bölüm Original Research
Yazarlar

Hilmi Tokmakoğlu Bu kişi benim

Özer Kandemir Bu kişi benim

Zeki Catav Bu kişi benim

Cem Yorgancıoğlu Bu kişi benim

Yaman Zorlutuna Bu kişi benim

Yayımlanma Tarihi 3 Aralık 2016
Yayımlandığı Sayı Yıl 2002 Cilt: 15 Sayı: 1

Kaynak Göster

APA Tokmakoğlu, H., Kandemir, Ö., Catav, Z., Yorgancıoğlu, C., vd. (2016). A COMPARISON OF CRYSTALLOID AND BLOOD INDUCTION CARDIOPLEGIA IN LOW - RISK PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING. Marmara Medical Journal, 15(1), 39-43.
AMA Tokmakoğlu H, Kandemir Ö, Catav Z, Yorgancıoğlu C, Zorlutuna Y. A COMPARISON OF CRYSTALLOID AND BLOOD INDUCTION CARDIOPLEGIA IN LOW - RISK PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING. Marmara Med J. Mart 2016;15(1):39-43.
Chicago Tokmakoğlu, Hilmi, Özer Kandemir, Zeki Catav, Cem Yorgancıoğlu, ve Yaman Zorlutuna. “A COMPARISON OF CRYSTALLOID AND BLOOD INDUCTION CARDIOPLEGIA IN LOW - RISK PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING”. Marmara Medical Journal 15, sy. 1 (Mart 2016): 39-43.
EndNote Tokmakoğlu H, Kandemir Ö, Catav Z, Yorgancıoğlu C, Zorlutuna Y (01 Mart 2016) A COMPARISON OF CRYSTALLOID AND BLOOD INDUCTION CARDIOPLEGIA IN LOW - RISK PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING. Marmara Medical Journal 15 1 39–43.
IEEE H. Tokmakoğlu, Ö. Kandemir, Z. Catav, C. Yorgancıoğlu, ve Y. Zorlutuna, “A COMPARISON OF CRYSTALLOID AND BLOOD INDUCTION CARDIOPLEGIA IN LOW - RISK PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING”, Marmara Med J, c. 15, sy. 1, ss. 39–43, 2016.
ISNAD Tokmakoğlu, Hilmi vd. “A COMPARISON OF CRYSTALLOID AND BLOOD INDUCTION CARDIOPLEGIA IN LOW - RISK PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING”. Marmara Medical Journal 15/1 (Mart 2016), 39-43.
JAMA Tokmakoğlu H, Kandemir Ö, Catav Z, Yorgancıoğlu C, Zorlutuna Y. A COMPARISON OF CRYSTALLOID AND BLOOD INDUCTION CARDIOPLEGIA IN LOW - RISK PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING. Marmara Med J. 2016;15:39–43.
MLA Tokmakoğlu, Hilmi vd. “A COMPARISON OF CRYSTALLOID AND BLOOD INDUCTION CARDIOPLEGIA IN LOW - RISK PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING”. Marmara Medical Journal, c. 15, sy. 1, 2016, ss. 39-43.
Vancouver Tokmakoğlu H, Kandemir Ö, Catav Z, Yorgancıoğlu C, Zorlutuna Y. A COMPARISON OF CRYSTALLOID AND BLOOD INDUCTION CARDIOPLEGIA IN LOW - RISK PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING. Marmara Med J. 2016;15(1):39-43.