ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Comparison of intermittent antegrade cardioplegia and antegrade/retrograde continuous cardioplegia in terms of myocardial protection in cardiac surgery
Murat Aksun1, Senem Girgin1, Saliha Aksun2, Mert Kestelli3, Şahin Bozok4, İsmail Yürekli3, Derya Kuyucu1, Atilla Şencan1, Ali Gürbüz3, Nagihan Karahan1
1Departments of Anaesthesiology and Reanimation, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey
2Departments of Medical Biochemistry, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey
3Departments of Cardiovascular Surgery, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey
4Department of Cardiovascular Surgery, Recep Tayyip Erdoğan University, Rize Training and Research Hospital, Rize, Turkey
DOI : 10.5606/tgkdc.dergisi.2015.10182
Background: This study aims to compare intermittent antegrade cardioplegia and antegrade/retrograde continuous cardioplegia in terms of myocardial protection in cardiac surgery.

Methods: Hundred six patients who underwent cardiac surgery in our clinic between October 2010 and January 2011 were included in the study. Patients were divided into two groups as patients who received intermittent antegrade cardioplegia (group 1; 18 females, 14 males) and who received antegrade/retrograde continuous cardioplegia (group 2; 16 females, 58 males), and postoperative results were compared. Troponin-I, creatine kinase-myocardial band (CK-MB) levels, durations of cardiopulmonary bypass (CPB) and cross-clamping, total amounts of cardioplegia, and potassium utilization during the process were evaluated.

Results: According to our results, mean troponin-I and CK-MB levels were higher in group 1 than group 2. However, this difference was not statistically significant. While troponin-I and CK-MB values were correlated to durations of cross-clamping and CPB in group 1, troponin-I and CK-MB values were not correlated to durations of cross-clamping and CPB in group 2.

Conclusion: No correlation was detected between troponin I, CK-MB levels, and durations of CPB and cross-clamping in the group which received anterograde/retrograde continuous cardioplegia. Therefore, troponin-I and CK-MB levels were not affected and myocardial protection was better once effective myocardial protection was obtained by antegrade/retrograde continuous cardioplegia. Although antegrade/retrograde continuous cardioplegia provides better myocardial protection, aortic pressure must be monitored to be kept between desired levels during antegrade cardioplegia, and the retrograde cannula must be kept in the appropriate place during retrograde cardioplegia.

Keywords : Cardioplegia, coronary bypass surgery, myocardial injury, myocardial protection
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