Hyperkalemic Blood versus Crystalloid Cardioplegia in Longer Clamping Times

• Published in: Asian cardiovascular & thoracic annals Vol. 12; no. 2; pp. 115 - 120
• Main Authors: Albert, Alexander A, Arnrich, Bert, Walter, Jorg A, Hassanein, Wael M, Rosendahl, Ulrich P, Gehle, Petra, Schon, Frank, Ennker, Jurgen
• Format: Journal Article
• Language: English
• Published: London, England Asian Soc Cardio Surg 01-06-2004; SAGE Publications
• Subjects: Biomarkers - blood; Coronary Artery Bypass - instrumentation; Coronary Disease - blood; Coronary Disease - physiopathology; Coronary Disease - therapy; Creatine Kinase - drug effects; Creatine Kinase - metabolism; Creatine Kinase, MB Form; Germany - epidemiology; Humans; Incidence; Intra-Aortic Balloon Pumping; Isoenzymes - drug effects; Isoenzymes - metabolism; Multivariate Analysis; Potassium Compounds - blood; Potassium Compounds - therapeutic use; Predictive Value of Tests; Statistics as Topic; Stroke Volume - physiology; Surgical Instruments; Time Factors; Treatment Outcome; Germany
• ISSN: 0218-4923; 1816-5370
• DOI: 10.1177/021849230401200207

The 715 patients who had crystalloid cardioplegia were compared with 5419 who had cold hyperkalemic blood cardioplegia for isolated coronary artery grafting from 1996 through 2001. Creatine kinase-MB was measured preoperatively, at 90 min, and 7 hours after the end of extracorporeal circulation. Correlation of post-bypass creatine kinase-MB release with aortic crossclamp time and other variables in the two cardioplegia groups was made using dichotomous encoding of cardioplegia in a multivariate linear regression model. Creatine kinase-MB levels 90 min after bypass were higher in patients who had crystalloid cardioplegia than in those who had blood cardioplegia. There was a linear relationship between aortic crossclamp time and post-bypass creatine kinase-MB release in both cardioplegia groups. Post-bypass creatine kinase-MB release increased with aortic crossclamp time independently of other factors and significantly more with crystalloid cardioplegia than with blood cardioplegia (the slope of the regression line was 0.230 versus 0.106). Intraaortic balloon pumping was used less frequently in the blood cardioplegia group. There was an advantage with blood cardioplegia for myocardial protection in longer aortic crossclamp times for isolated coronary bypass grafting.