Leukocyte-depleted continuous blood cardioplegia for coronary artery bypass grafting

Many cardiac surgeries are performed with blood cardioplegia. However, some studies suggest that activated neutrophils form blood cardioplegia can cau se reperfusion injury. In this study we assessed myocardial protection usin g a leukocyte-depleted cardioplegic solution. Patients undergoing elective coronary artery bypass grafting (CABG) with co ntinuous blood cardioplegia were divided into two groups: the LD group, whi ch received leukocyte-depleted blood cardioplegia (n = 11); and the control group, which received nonfiltered blood cardioplegia (n = 11). IL-6, IL-8, CK-MB, and troponin T were measured in the coronary sinus blood immediatel y after the release of the aortic cross-clamp, Cytokine concentrations were also measured upon the patient's return to the ICU. The total dopamine and dobutamine doses, hemodynamic measurements after surgery, and the leukocyt e filtration rate were also measured. During antegrade cardioplegia infusion, leukocytes were almost completely r emoved (filtration rate: 85.8 +/- 4.0%). However, during terminal warm card ioplegia, leukocyte removal decreased (filtration rate: 39.9 +/- 7.8%). Imm ediately after the release of the aortic cross-clamp, plasma CK-MB and trop onin T concentrations were significantly lower in the LD group (17.7 +/- 1. 9 U / l and 0.017 +/- 0.002 ng / ml, respectively) than in the control grou p (30.3 +/- 3.6 U / l and 0.072 +/- 0.029 ng / ml, respectively). The IL-6 and IL-8 concentrations were similar in the LD group and the control group. After the return to the ICU, the CK-MB and troponin T concentrations were similar in the two groups. No significant differences were found in the tot al doses of dopamine or dobutamine after surgery in the two groups (99 +/- 77 vs 101 +/- 128 mug / kg / min). No significant differences were found in the hemodynamic parameters after surgery in the two groups. In patients undergoing CABG with continuous blood cardioplegia, leukocyte-d epleted blood cardioplegic solution may attenuate reperfusion injury.