ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Continuous retrograde coronary sinüs isothermic blood cardioplegia with no antegrade combination in aortic valve surgery
Mustafa GÜLER, Esat AKINCI, Bahadır DAĞLAR, Kaan KIRALİ, Ercan EREN, Mehmet BALKANAY, Turan BERKİ, Ali GÜRBÜZ, Cevat YAKUT
Koşuyolu Kalp ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İSTANBUL
40 patients with isolated aortic stenosis were included in this study. The patients were studied in two groups which showed similar features. In group I (20 patients) intraoperative myocardial protection was provided with continuous retrograde isothermic blood cardioplegia with no antegrade component. In group II (20 patients) hypothermic crystalloid cardioplegia was used far induction, than on intermittant hypothermic blood cardioplegia was used in antegrade fashion.

Both of groups were evaluated hemodinamically and clinically.

There was no difference between two groups in cardiopulmonary bypass, aortic cross-clamp time and mean arrest time as perioperative features.

Patient temperature and cardioplegia volume in group I was significantly higher than group II [Patient temperature (°C) group I: 31.2±2.52, group II 28.3±1.72, p<0.05, Cardioplegia volume (1) group I: 6.5±1.98, group II: 1.6±0.43, p<0.05].

The significance of preoperative (Group Ia,IIa) and postoperative (Group lb,IIb) hemodynamic variations were compared. The cardiac index and right ventricular stroke work index of both groups were not found to be significant (p>0.05). The increase of stroke index and left ventricular stroke work index between the groups vvere found to be significant (p<0.05). Commencement of spontaneous sinüs rhythm after de-cross-clamping occured in 18 patients of group I (90%) and 12 patients of group II (60%) (p<0.05).There was no significant difference beetween the two groups in inotropic support, low cardiac output, atrial arrhythmias, and ventricular arrhythmias.

In conclusion, continuous retrograde isothermic blood cardioplegia with no antegrade component is a safe and effective method of myocardial protection during aortic valve surgery especially in hypertrophied cases.

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