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The Journal of Thoracic and Cardiovascular Surgery, Vol 88, 287-293, Copyright © 1984 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
C Bull, J Cooper and J Stark
The advantages and limitations of cardioplegia as a mode of myocardial
preservation in the pediatric cardiac surgical context are investigated.
Review of early mortality related to ischemic time demonstrated no
difference in overall mortality in consecutive series each of 200 patients,
the first protected by reperfusion between intermittent periods of aortic
cross-clamping and the second protected by cardioplegia. There was a
tendency to accept longer ischemic time with cardioplegia (p less than
0.01). Mortality with cardioplegia increased sharply beyond 85 minutes of
ischemia. Cytochemical and biophysical assessment of 129 pairs of right
ventricular biopsy specimens taken before and after ischemia usually
demonstrated deterioration of myocardium despite cardioplegia, and poor
scores were predictive of hospital death. Use of a logistic analysis
suggested that about half the hospital deaths were attributable to
inadequate myocardial preservation despite cardioplegia.
ARTICLES
Cardioplegic protection of the child's heart
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