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J Thorac Cardiovasc Surg 1998;115:1166-1171
© 1998 Mosby, Inc.

CARDIOPULMONARY SUPPORT AND PHYSIOLOGY

Prospective, randomized trial comparing blood and oxygenated crystalloid cardioplegia in reoperative coronary artery bypass grafting

From the Departments of Anesthesiology and Surgery, Emory University School of Medicine, Department of Biostatistics, Rollins School of Public Health at Emory University, Atlanta, Ga.

Read at the Meeting of the Society of Cardiovascular Anesthesiologists, May 8, 1996, Salt Lake City, Utah.

Received for publication April 25, 1997. Revisions requested July 21, 1997; revisions received Nov. 14, 1997. Accepted for publication Nov. 14, 1997. Address for reprints: Jack S. Shanewise, MD, Department of Anesthesiology, Emory University Hospital, 1364 Clifton Rd., Atlanta, GA 30322.

Objectives: Reoperative coronary artery bypass grafting presents unique challenges for myocardial preservation. The purpose of this study was to compare oxygenated blood cardioplegia with oxygenated crystalloid cardioplegia during reoperative coronary artery bypass grafting using transesophageal echocardiography to assess regional wall motion of the left ventricle before and after cardiopulmonary bypass.
Methods: Sixty-one patients undergoing reoperative coronary artery bypass grafting were prospectively randomized to receive oxygenated blood cardioplegia or oxygenated crystalloid cardioplegia delivered with a combined antegrade-retrograde technique. Transgastric short axis views of the left ventricle were made with transesophageal echocardiography during the operation before cardiopulmonary bypass and immediately after cardiopulmonary bypass. Regional wall motion was graded by a blinded observer, and before cardiopulmonary bypass scores were compared with after cardiopulmonary bypass scores.
Results: No significant differences were found in the change in regional wall motion score from before cardiopulmonary bypass to after cardiopulmonary bypass between the blood and crystalloid cardioplegia groups.
Conclusions: This study found blood and crystalloid cardioplegia to be equally efficacious for myocardial preservation during reoperative coronary artery bypass grafting.

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