Hemodynamics during First Hours after Surgery Using Cardiopulmonary Bypass - Crystalloid versus Blood Cardioplegia

Overview

We sought to determine if hemodynamic parameters after surgery using cardiopulmonary bypass are affected by the type of cardioplegic solutionused – crystalloid or blood. Sixty patients with left ventricle ejection fraction < 35 % scheduled for coronary artery bypass surgery were randomizedinto two groups. In the first group cold blood cardioplegia was used, in the other cold crystalloid cardioplegia was used. We collected hemodynamicdata before the procedure and at one, two, four and six hours after weaning from cardiopulmonary bypass, and on the first postoperative day. We alsocollected clinical data reflecting perioperative myocardial preservation.No patient died in any group. We did not find significant difference between the incidence of perioperative myocardial infarction, arrhythmia andthe need for intraaortic balloon pump use in the postoperative period. In the early postoperative course we found significantly better hemodynamicdata in the group with blood cardioplegia (LVSWI, RVSWI).Blood cardioplegia ensured better perioperative myocardial preservation which resulted in faster restoration of myocardial functions. This differencecould be of significance in patients with severe dysfunction of the left ventricle.

Key words:
cardioplegia - hemodynamics - coronary artery bypass surgery - dysfunction