PROSPECTIVE, RANDOMIZED TRIAL COMPARING BLOOD AND OXYGENATED CRYSTALLOID CARDIOPLEGIA IN REOPERATIVE CORONARY-ARTERY BYPASS-GRAFTING

Objectives: Reoperative coronary artery bypass grafting presents uniqu e challenges for myocardial preservation. The purpose of this study wa s to compare oxygenated blood cardioplegia with oxygenated crystalloid cardioplegia during reoperative coronary artery bypass grafting using transesophageal echocardiography to assess regional wall motion of th e left ventricle before and after cardiopulmonary bypass. Methods: Six ty-one patients undergoing reoperative coronary artery bypass grafting were prospectively randomized to receive oxygenated blood cardioplegi a or oxygenated crystalloid cardioplegia delivered with a combined ant egrade-retrograde technique. Transgastric short axis views of the left ventricle were made with transesophageal echocardiography during the operation before cardiopulmonary bypass and immediately after cardiopu lmonary bypass. Regional wall motion was graded by a blinded observer, and before cardiopulmonary bypass scores were compared with after car diopulmonary bypass scores. Results: No significant differences were f ound in the change in regional wall motion score from before cardiopul monary bypass to after cardiopulmonary bypass between the blood and cr ystalloid cardioplegia groups. Conclusions: This study found blood and crystalloid cardioplegia to be equally efficacious for myocardial pre servation during reoperative coronary artery bypass grafting.