ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
THE USE OF TEPID BLOOD CARDIOPLEGIA IN MYOCARDIAL PROTECTION AND ITS IMPACT ON LEFT VENTRICULAR FUNCTIONS
Berent DİŞCİGİL, Uğur GÜRCÜN, M. İsmail BADAK, Mehmet BOĞA, Erdem ÖZKISACIK, Alp ALAYUNT, Suat BUKET, İsa DURMAZ, Önol BİLKAY
Adnan Menderes Ünviversitesi Tıp Fakakültesi, Kalp Damar Cerrahisi Anabilim Dalı, AYDIN
Purpose:

Cold blood cardiyoplegia and normothermic blood cardioplegia are widely used miyocardial protection methods. Tepid blood cardiyoplegia has also been in use in recent years and has the advantages of both methods. The aim of this study was to evaluate left ventricular function following the use of tepid blood cardiyoplegia.

Materials and Methods:

Thirty patients who underwent coronary artery bypass grafting were studied in two groups (tepid and cold), 15 patients in each. Mean age was 57.9 ± 10.4 years in tepid group and 59.2 ± 7.6 years in cold group. Hemodynamic parameters were measured before and immediate after cardiyopulmonary bypass (CPB), in postoperative 4th, 12th and 24th hours. Blood creatinine phosphokinase (CPK) and its miyocardial isoenzyme (CK-MB) levels were measured in 6 different time periods postoperatively to assess the degree of myocardial injury.

Results:

Left ventricular stroke work index (LVSWI) calculated value was higher in tepid group than it was in cold group immediate after CPB and in 4th hour postoperatively (p<0.05). In these time periods, pulmonary capillary wedge pressure (PCWP) values did not rise as high as LVSWI suggesting better left ventricular diastolic compliance. CK-MB isoenzyme levels were lower in tepid group patients in 6th, 12th and 24th hours postoperatively (p<0.05).

Conclusion:

These findings demonstrate that the use of tepid blood cardiyoplegia was more effective in maintaining better left ventricular functions compared to cold blood cardiyoplegia. In open heart surgery, tepid blood cardiyoplegia is a good alternative method of miyocardial protection.

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