This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Mohamed F. Ibrahim Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ibrahim, M. F. Articles by Refaat, A. A. Search for Related Content PubMed Articles by Ibrahim, M. F. Articles by Refaat, A. A. Related Collections Related Article

Long-term outcome after coronary artery bypass grafting in patients with left ventricular dysfunction: does the type of cardioplegia matter?

PSHC, King Fahd Medical City, Riyadh, Saudi Arabia

Is blood cardioplegia superior to crystalloid cardioplegia?

I read with interest Mr. Jacob's best evidence topic entitled ‘Is blood cardioplegia superior to crystalloid cardioplegia?’ [1]. I congratulate him and his colleagues for the efforts made to reach an answer on this issue. We all know that there still is controversy regarding which cardioplegic solution, temperature and route of administration is superior to others. There is also evidence as shown by Jacob et al. that there is enhanced postoperative myocardial protection with cold blood cardioplegia. We know also that high risk patients such as the ones with left ventricular dysfunction benefit most from optimal cardioplegia. Our study [2] is one of the papers mentioned in Jacob et al. paper. We attempted to answer the question of whether the cardioplegic type affect outcome and survival in patients in the study group. We had nine years follow-up of this group of patients by contacting their general practitioners, primary health authorities and telephone interviews with patients and their families. We found out that 1, 3, 5, 8-year survival was 96%, 92%, 88%, 76% in the blood group and 100%, 100%, 96%, 88% for the crystalloid group. There was no difference in the incidence of myocardial infarction between both groups. There was increased incidence of recurrence of angina and the rate of re-intervention in the crystalloid group but did not reach a statistical significance. We conclude that St Thomas' No 1 cold blood cardioplegic solution enhanced immediate postoperative myocardial protection, but has no advantage on long-term mortality or morbidity.

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1. Jacob S, Kallikourdis A, Sellke F, Dunning J. Is blood cardioplegia superior to crystalloid cardioplegia? Interact CardioVasc Thorac Surg 2008;7:491–499.[Abstract/Free Full Text]
2. Ibrahim MF, Venn GE, Young CP, Chambers DJ. A clinical comparative study between crystalloid and blood-based St Thomas' hospital cardioplegic solution. Eur J Cardiothorac Surg 1999;15:75–83.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Mohamed F. Ibrahim Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ibrahim, M. F. Articles by Refaat, A. A. Search for Related Content PubMed Articles by Ibrahim, M. F. Articles by Refaat, A. A. Related Collections Related Article