Myocardial Protection with Simultaneous Antegrade/Vein Graft Cardioplegia Compared to Antegrade Cardioplegia Alone in Elective Coronary Artery Bypass Grafting Patients

Abstract

Objective: Cardioplegia distribution beyond a stenotic coronary artery may not be adequate. This problem can be overcome by direct delivery of cardioplegia via the vein grafts anastomosed during the operation. The aim of this study is to investigate the results of simultaneous antegrade/vein graft cardioplegia versus antegrade cardioplegia alone in elective CABG patients. Material and Methods: Forty consecutive patients were randomized into the study group to whom antegrade/vein cardioplegia and to the control group to whom only antegrade cardioplegia was given. Both groups were similar with respect to demographic characteristics, postoperative ECG changes and arrhythmia in the ICU, as well as in terms of operative and postoperative variables (p>0.05). Results: All patients had excellent operative and postoperative periods without any complications or death. Release of total CK, CKMB, cTnI and lactate did not differ in the preoperative and the first 12(th) hour (p>0.05) between the groups, whereas in the study group a peak for total CK, CKMB, cTnI and lactate, consistent with myocardial injury (p<0.05), was found in the first 24(th) hour, which returned in the 48(th) hour (p>0.05). Conclusion: The primary finding of this study is the inferiority of myocardial protection with simultaneous antegrade/vein graft cardioplegia compared with antegrade cardioplegia alone.