WARM BLOOD CARDIOPLEGIA FOR PATIENTS UNDERGOING REVASCULARIZATION FORLEFT MAIN CORONARY-ARTERY DISEASE

Between February 1991 and June 1992, 62 patients (50 males) underwent coronary artery bypass (CAB) operation for significant left main coron ary artery disease. Age varied between 47 and 81 years. 53 patients ha d unstable angina, 16 had recent myocardial infarction, and 16 had hea rt failure. 22 patients were in functional capacity class IV (Canadian Heart Association) and 2 patients were in unstable hemodynamical cond ition before the operation. Intraaortic balloon pump was inserted befo re the operation in 3 patients. Six patients had previous CAB surgery. All the patients were operated using myocardial protection with warm blood cardioplegia, given antegradely and retrogradely in 58 and only antegradely in 4 patients. Body temperature was maintained at 30 +/- 1 .8-degrees-C. Number of distal anastomoses averaged 4.3 +/- 0.9. One p atient underwent additional resection of a left atrial myxoma and anot her aortic valve replacement. LIMA (left internal mammary artery) was used to bypass the LAD in 58 (94 %) patients. Early mortality was 3 ca ses (4.8 %). Major and minor postoperative complications occurred in 1 7 patients. These data suggest that warm blood cardioplegia provides s uperior myocardial protection in patients with left main coronary arte ry disease.