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Comparison of the immediate post-operative outcome of two different myocardial protection strategies: antegrade–retrograde cold St Thomas blood cardioplegia versus intermittent cross-clamp fibrillation

Castle Hill Hospital, Hull, UK

^* Corresponding author. The Cottage, Main Road, Covenham St Bartholomew, Louth LN11 0PF, UK. Tel./fax: +44-1507-363541
mrjosephalex{at}yahoo.co.uk

The objective of this study was to compare the immediate post-operative outcome of two myocardial protection strategies. Data of consecutive elective first time coronary artery bypass grafting (CABG) were analysed: Group A (, antegrade–retrograde cold St Thomas blood cardioplegia) and Group B (, intermittent cross-clamp fibrillation). Age, angina class, myocardial infarction (MI), pre-operative rhythm, respiratory disease, smoking, diabetes mellitus (DM), hypertension (HT), renal function, cerebrovascular disease, body mass index (BMI) and Parsonnet score were comparable. Significant differences existed in gender (), peripheral vascular disease (PVD) (), heart failure class (), left ventricular (LV) function (), disease severity (), left main stem (LMS) () and preinduction intra-aortic balloon pump(IABP) (). Group A had more grafts (), longer bypass () and cross-clamp time (). Post-operative inotrope, MI, arrhythmias, neurological, renal complications, multi-organ failure, sternal re-wiring, ventilation, length of stay and mortality were comparable. There was higher IABP usage and longer intensive therapy unit (ITU) stay () in Group B. Chronic obstructive airway disease (COAD), renal dysfunction, cross-clamp time, bypass time, post-operative inotrope or IABP and re-exploration predicted longer ITU stay. Intermittent cross-clamp fibrillation is a versatile and cost-effective method of myocardial protection, with the immediate post-operative outcome comparable to antegrade–retrograde cold St Thomas blood cardioplegia in elective first-time CABG.

Key Words: Coronary artery bypass grafting; Myocardial protection; Outcome

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