CRYSTALLOID VERSUS COLD BLOOD CARDIOPLEGIA IN PATIENTS OPERATED ON FOR MYOCARDIAL REVASCULARIZATION

Post-ischemic reperfusion phenomenon has been studied in two methods o f myocardial protection: a crystalloid cardioplegia (St Thomas no, 2) and a cold blood cardioplegia (Buckberg) during cardiopulmonary bypass for myocardial revascularisation in patients. Myocardial protection h as been assessed from the evolution of hemodynamic parameters, reperfu sion arrhythmias and biochemical analysis of the coronary now after cr oss-clamp removal: creatinine phosphokinase (CPK-MB) and nucleotide ad enine metabolites (adenosine, inosine, hypoxanthine, xanthine and uric acid). The study was performed in two groups of 14 patients. Hemodyna mic conditions were similar in both groups during reperfusion in order to avoid different coronary flow. In those conditions, myocardial pro tection by cold blood cardioplegia reduced reperfusion arrhythmias, an d resulted in a loss of CPK-MB release. Furthermore, the reduction of metabolites release, purine bases and oxypurine bases into coronary si nus after cold blood cardioplegia suggest a better protection of myoca rdial high energy phosphates in this group than after crystalloid card ioplegia. Our results also show that hypoxanthine is probably the fina l product of ATP degradation in human myocardial tissue.