| Efficacy of Combined
Antegrade and Retrograde Intermittent Cold Cardioplegia for Patients
with Prolonged Aortic Cross-Clamping |
(Department of Thoracic and Cardiovascular Surgery,
Tohoku University, Sendai, Japan)
| Makoto Kamada |
Atushi Iguchi |
Motohisa Tofukuji |
| Hitoshi Yokoyama |
Hiroji Akimoto |
Mikio Ohmi |
| Koichi Tabayashi |
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We evaluated the efficacy
of combined antegrade and retrograde intermittent cold cardioplegia
for patients with prolonged aortic cross-clamping. Thirty patients
with cross-clamping time of more than 4 h were divided into three
groups according to the method of cardioplegia. Antegrade crystalloid
cardioplegia was performed in 9 cases, combined antegrade and
retrograde crystalloid cardioplegia was performed in 5 cases,
and combined antegrade and retrograde cold blood cardioplegia
was performed in 16 cases. There was no statistical difference
in mean aortic cross-clamping time among the three groups. The
hospital mortality was 33% in the antegrade crystalloid group,
20% in the combined crystalloid group, and 0% in the combined
blood group. There was a significant statistical difference in
the hospital mortality between the antegrade crystalloid and
combined blood group. The incidence of low cardiac output syndrome
(LOS) was 67% in the antegrade crystalloid group, 20% in the
combined crystalloid group, and 6% in the combined blood group.
There was a significant difference in the incidence of LOS between
antegrade crystalloid and combined blood groups. The recovery
rate of spontaneous rhythm after the release of the cross-clamp
was also significantly greater in the combined blood group than
in the antegrade crystalloid group. In conclusion, combined antegrade
and retrograde intermittent cold cardioplegia provides excellent
myocardial protection for patients with prolonged aortic cross-clamping.
Jpn. J. Cardiovasc. Surg. 29: 127-133 (2000) |
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