IS CONTINUOUS WARM RETROGRADE BLOOD CARDIOPLEGIA COMPLETELY SAFE FOR CORONARY-ARTERY SURGERY

Sixty consecutive coronary patients operated on by the same team in 19 92 were divided into two groups: group 1 (30 patients) using intermitt ent oxygenated cold Fresenius solution antegrade and retrograde (FR), group 2 (30 patients) using warm retrograde blood cardioplegia (WRC) w ith the Fremes solution initially antegrade and retrograde (high potas sium solution) then continuous retrograde low potassium solution. All patients were submitted to only arterial grafts (3 to 4) using both in ternal mammary arteries and the right gastroepiploic artery. There wer e no differences in mean preoperative data between the 2 groups. The t imes of aortic cross-clamping (P < 0.05) and bypass after release of t he aortic clamp (P < 0.01) were significantly higher in the WRC group. No significant difference was observed in the number of postoperative supraventricular arrhythmias or electrocardiographic infarctions. A s ignificant difference was observed with higher values of the enzymes ( aspartate amino transferase, creatine kinase) for the WRC group on the first (P < 0.05) and the second postoperative days (P < 0.01). More p atients in the WRC group received vasoactive or inotropic drugs in the intensive care unit, where they stayed a longer time because of hemod ynamic instability or enzyme elevation (P < 0.05). In conclusion, for coronary arterial revascularization, WRC is technically more demanding and does not appear to afford optimal myocardial protection.