BACKGROUND: In a prospective randomised clinical study we assessed and compared antegrade vs. combined antegrade-retrograde cardioplegia in patients who underwent elective coronary artery by pass grafting. METHODS:Between March 2006 and January 2007, 87 consecutive patients were randomly divided into two groups. Group A (n=45) received antegrade cold (4 degrees C) blood cardioplegia. Besides antegrade cardioplegia, Group B (n=42) received continuous retrograde cardioplegia passively by gravitational force. The need for cardiac support during and after cardiopulmonary bypass, post-operative morbidity, ICU stay, hospital stay and mortality were compared in two groups. RESULTS: There was no significant difference between the two groups in gender, age and pre-operative ejection fraction. Sixteen patients in Group A (35.5%) and eight patients in Group B (19%) needed inotropic support while weaning off cardiopulmonary bypass (p=0.04). Four patients in Group A (8.9%) and two patients in Group B (4.8%) needed intra-aortic balloon pump (p=0.44) in the ICU. We found no statistically important difference between the two groups in post-operative morbidity and mortality. CONCLUSIONS: Retrograde continuous infusion of cardioplegia by gravitational force combined with antegrade cardioplegia, provides satisfactory myocardial protection and eliminates the need for inotropic support compared with antegrade technique alone.
RCT Entities:
BACKGROUND: In a prospective randomised clinical study we assessed and compared antegrade vs. combined antegrade-retrograde cardioplegia in patients who underwent elective coronary artery by pass grafting. METHODS: Between March 2006 and January 2007, 87 consecutive patients were randomly divided into two groups. Group A (n=45) received antegrade cold (4 degrees C) blood cardioplegia. Besides antegrade cardioplegia, Group B (n=42) received continuous retrograde cardioplegia passively by gravitational force. The need for cardiac support during and after cardiopulmonary bypass, post-operative morbidity, ICU stay, hospital stay and mortality were compared in two groups. RESULTS: There was no significant difference between the two groups in gender, age and pre-operative ejection fraction. Sixteen patients in Group A (35.5%) and eight patients in Group B (19%) needed inotropic support while weaning off cardiopulmonary bypass (p=0.04). Four patients in Group A (8.9%) and two patients in Group B (4.8%) needed intra-aortic balloon pump (p=0.44) in the ICU. We found no statistically important difference between the two groups in post-operative morbidity and mortality. CONCLUSIONS: Retrograde continuous infusion of cardioplegia by gravitational force combined with antegrade cardioplegia, provides satisfactory myocardial protection and eliminates the need for inotropic support compared with antegrade technique alone.
Authors: Luciano Candilio; Abdul Malik; Con Ariti; Sherbano A Khan; Matthew Barnard; Carmelo Di Salvo; David R Lawrence; Martin P Hayward; John A Yap; Amir M Sheikh; Christopher G A McGregor; Shyam K Kolvekar; Derek J Hausenloy; Derek M Yellon; Neil Roberts Journal: J Cardiothorac Surg Date: 2014-12-31 Impact factor: 1.637
Authors: Andreas Habertheuer; Alfred Kocher; Günther Laufer; Martin Andreas; Wilson Y Szeto; Peter Petzelbauer; Marek Ehrlich; Dominik Wiedemann Journal: Biomed Res Int Date: 2014-09-08 Impact factor: 3.411