| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
The Journal of Thoracic and Cardiovascular Surgery, Vol 104, 608-618, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
FD Loop, TL Higgins, R Panda, G Pearce and FG Estafanous
The efficacy of myocardial protection with a single aortic crossclamp and
blood cardioplegia was evaluated in 819 consecutive patients stratified for
preoperative condition by means of a new clinical risk scoring system. A
protocol using either antegrade or antegrade/retrograde blood cardioplegia
was compared with antegrade crystalloid cardioplegia in 2582 similar,
consecutive, and concurrent patients. In the blood cardioplegia cohort, 97
(11.8%) patients had 129 complications compared with 407 (15.8%) patients
and 675 complications in the crystalloid cardioplegia group (p = 0.006). In
high-risk patients, combined antegrade/retrograde cardioplegia
significantly reduced myocardial infarction, stroke, and respiratory and
wound complications. Despite the significantly longer aortic crossclamp
time required for blood cardioplegia, patients undergoing crystalloid
cardioplegia were 1.7 (95% confidence interval 1.3, 2.1) times more likely
to have a morbid event. Time in the intensive care unit, length of
hospitalization, and length-of-stay outlier status were significantly
decreased in the blood cardioplegia compared with the crystalloid
cardioplegia group. The net savings in hospital cost amounted to $2196 per
case. When compared separately with crystalloid cardioplegia, combined
antegrade/retrograde blood cardioplegia accounted for most of the morbidity
reduction by significantly reducing perioperative myocardial infarction,
wound complications, and length of stay in patients having reoperations.
Antegrade/retrograde blood cardioplegia did not influence 1-year survival
or event-free survival, even when risk was considered.
ARTICLES
Myocardial protection during cardiac operations. Decreased morbidity and lower cost with blood cardioplegia and coronary sinus perfusion
Department of Thoracic, Cleveland Clinic Foundation, Ohio 44195.
This article has been cited by other articles:
|
|
 |
|
  P. Lamm, K. Adelhard, G. Juchem, R. Weitkunat, S. Milz, E. Kilger, A. Gotz, and B. Reichart Fibrin glue in coronary artery bypass grafting operations: casting out the Devil with Beelzebub? Eur. J. Cardiothorac. Surg., October 1, 2007; 32(4): 567 - 572. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Martin and C. Benk Blood cardioplegia MMCTS, October 9, 2006; 2006(1009): 745. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Bezon, J. N. Choplain, A. A. Aziz Khalifa, H. Numa, N. Salley, and J. A. Barra Continuous retrograde blood cardioplegia ensures prolonged aortic cross-clamping time without increasing the operative risk Interactive CardioVascular and Thoracic Surgery, August 1, 2006; 5(4): 403 - 407. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. W. Quinn, D. Pagano, R. S. Bonser, S. J. Rooney, T. R. Graham, I. C. Wilson, B. E. Keogh, J. N. Townend, M. E. Lewis, P. Nightingale, et al. Improved myocardial protection during coronary artery surgery with glucose-insulin-potassium: A randomized controlled trial J. Thorac. Cardiovasc. Surg., January 1, 2006; 131(1): 34 - 42. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. P. Siegenthaler Antegrade administration of cardioplegia MMCTS, June 28, 2005; 2005(0628): 695. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S W Sutton, A N Patel, V A Chase, L A Schmidt, E K Hunley, L W Yancey, R F Hebeler, E H Cheung, A C Henry III, T P Meyers, et al. Clinical benefits of continuous leukocyte filtration during cardiopulmonary bypass in patients undergoing valvular repair or replacement Perfusion, January 1, 2005; 20(1): 21 - 29. [Abstract] [PDF]
|
|
|
|
|
|
E. Ovrum, G. Tangen, S. Tollofsrud, R. Oystese, M. A. L. Ringdal, and R. Istad Cold blood cardioplegia versus cold crystalloid cardioplegia: A prospective randomized study of 1440 patients undergoing coronary artery bypass grafting J. Thorac. Cardiovasc. Surg., December 1, 2004; 128(6): 860 - 865. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. A Albert, B. Arnrich, J. A Walter, W. M Hassanein, U. P Rosendahl, P. Gehle, F. Schon, and J. Ennker Hyperkalemic Blood versus Crystalloid Cardioplegia in Longer Clamping Times Asian Cardiovasc Thorac Ann, June 1, 2004; 12(2): 115 - 120. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Kuralay, F. Cingoz, S. Kilic, C. Bolcal, C. Gunay, U. Demirkilic, and H. Tatar Supraventricular tachyarrythmia prophylaxis after coronary artery surgery in chronic obstructive pulmonary disease patients (early amiodarone prophylaxis trial) Eur. J. Cardiothorac. Surg., February 1, 2004; 25(2): 224 - 230. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Medalion, M. G. Katz, A. J. Cohen, E. Hauptman, L. Sasson, and A. Schachner Long-term Beneficial Effect of Coronary Artery Bypass Grafting in Patients With COPD Chest, January 1, 2004; 125(1): 56 - 62. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Alex, V. P. Rao, A. R.J. Cale, S. C. Griffin, M. E. Cowen, and L. Guvendik Surgical nurse assistants in cardiac surgery: a UK trainee's perspective Eur. J. Cardiothorac. Surg., January 1, 2004; 25(1): 111 - 115. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Alex, J. Ansari, R. Guerrero, J. Yogarathnam, A. R.J. Cale, S. C. Griffin, M. E. Cowen, and L. Guvendik 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 Interactive CardioVascular and Thoracic Surgery, December 1, 2003; 2(4): 584 - 588. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. S. Jonjev, D. W. Schwertz, J. M. Beck, J. D. Ross, and W. R. Law Subcellular distribution of protein kinase C isozymes during cardioplegic arrest J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 1880 - 1885. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. J. Flameng, P. Herijgers, S. Dewilde, and E. Lesaffre Continuous retrograde blood cardioplegia is associated with lower hospital mortality after heart valve surgery J. Thorac. Cardiovasc. Surg., January 1, 2003; 125(1): 121 - 125. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. W. Kim, D. C. Mariconda, G. Tellides, G. S. Kopf, M. L. Dewar, Z. Lin, and J. A. Elefteriades Single-clamp technique does not protect against cerebrovascular accident in coronary artery bypass grafting Eur. J. Cardiothorac. Surg., July 1, 2001; 20(1): 127 - 132. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Svedjeholm, E. Hakanson, Z. Szabo, and F. Vanky Neurological injury after surgery for ischemic heart disease: risk factors, outcome and role of metabolic interventions Eur. J. Cardiothorac. Surg., May 1, 2001; 19(5): 611 - 618. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. S. Lin, M. S. Lauer, C. R. Asher, D. M. Cosgrove, E. Blackstone, J. D. Thomas, and M. J. Garcia Prediction of coronary artery disease in patients undergoing operations for mitral valve degeneration J. Thorac. Cardiovasc. Surg., May 1, 2001; 121(5): 894 - 901. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. L. Lazar, C. A. Fitzgerald, T. Ahmad, Y. Bao, T. Colton, O. M. Shapira, and R. J. Shemin Early discharge after coronary artery bypass graft surgery: Are patients really going home earlier? J. Thorac. Cardiovasc. Surg., May 1, 2001; 121(5): 943 - 950. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. I. Dar, T. Gillott, F. Ciulli, and G. J. Cooper Single aortic cross-clamp technique reduces S-100 release after coronary artery surgery Ann. Thorac. Surg., March 1, 2001; 71(3): 794 - 796. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. D. Buckberg Substrate enriched warm blood cardioplegia reperfusion: an alternate view Ann. Thorac. Surg., February 1, 2000; 69(2): 334 - 335. [Full Text] [PDF]
|
|
|
|
|
|
F. Dagenais, L. C. Pelletier, and M. Carrier Antegrade/retrograde cardioplegia for valve replacement: a prospective study Ann. Thorac. Surg., November 1, 1999; 68(5): 1681 - 1685. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Krejca, J. Skiba, P. Szmagala, T. Gburek, and A. Bochenek Cardiac troponin T release during coronary surgery using intermittent cross-clamp with fibrillation, on-pump and off-pump beating heart Eur. J. Cardiothorac. Surg., September 1, 1999; 16(3): 337 - 341. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M.F. Elwatidy, M. A. Fadalah, E. A. Bukhari, K. A. Aljubair, A. Syed, A. K. Ashmeg, and M. R. Alfagih Antegrade crystalloid cardioplegia vs antegrade/retrograde cold and tepid blood cardioplegia in CABG Ann. Thorac. Surg., August 1, 1999; 68(2): 447 - 453. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. D. Loop Coronary artery surgery: the end of the beginning Eur. J. Cardiothorac. Surg., December 1, 1998; 14(6): 554 - 571. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Shanewise, A. S. Kosinski, J. A. Coto, and E. L. Jones Prospective, randomized trial comparing blood and oxygenated crystalloid cardioplegia in reoperative coronary artery bypass grafting J. Thorac. Cardiovasc. Surg., May 1, 1998; 115(5): 1166 - 1171. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. G. Estafanous, F. D. Loop, T. L. Higgins, S. Tekyi-Mensah, B. W. Lytle, D. M. Cosgrove Jr, and N. J. Starr Increased Risk and Decreased Morbidity of Coronary Artery Bypass Grafting Between 1986 and 1994 Ann. Thorac. Surg., February 1, 1998; 65(2): 383 - 389. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Sadony, M. Korber, G. Albes, V. Podtschaske, T. Etgen, T. Trosken, U. Ravens, and M. E. Scheulen Cardiac troponin I plasma levels for diagnosis and quantitation of perioperative myocardial damage in patients undergoing coronary artery bypass surgery Eur. J. Cardiothorac. Surg., January 1, 1998; 13(1): 57 - 65. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. L. Higgins, F. G. Estafanous, F. D. Loop, G. J. Beck, J.-C. Lee, N. J. Starr, W. A. Knaus, and D. M. Cosgrove III ICU Admission Score for Predicting Morbidity and Mortality Risk After Coronary Artery Bypass Grafting Ann. Thorac. Surg., October 1, 1997; 64(4): 1050 - 1058. [Abstract] [Full Text]
|
|
|
|
|
|
J. R. Handy Jr., B. H. Dorman, M. J. Cavallo, R. B. Hinton, R. C. Roy, F. A. Crawford, and F. G. Spinale DIRECT EFFECTS OF OXYGENATED CRYSTALLOID OR BLOOD CARDIOPLEGIA ON ISOLATED MYOCYTE CONTRACTILE FUNCTION J. Thorac. Cardiovasc. Surg., October 1, 1996; 112(4): 1064 - 1072. [Abstract] [Full Text]
|
|
|
|
|
|
R. H. Chen The Scientific Basis for Hypocalcemic Cardioplegia and Reperfusion in Cardiac Surgery Ann. Thorac. Surg., September 1, 1996; 62(3): 910 - 914. [Abstract] [Full Text]
|
|
|
|
|
|
D. P. Taggart, C. Atari, P. Wong, E. A. Paul, and J. E. Wright APPLICABILITY OF INTERMITTENT GLOBAL ISCHEMIA FOR REPEAT CORONARY ARTERY OPERATIONS J. Thorac. Cardiovasc. Surg., August 1, 1996; 112(2): 501 - 507. [Abstract] [Full Text]
|
|
|
|
|
|
H. C. Alhan, H. Karabulut, R. Tosun, F. Karakoc, I. Okar, E. Demiray, S. Tarcan, and B. Yigiter Intermittent Aortic Cross-Clamping and Cold Crystalloid Cardioplegia for Low-Risk Coronary Patients Ann. Thorac. Surg., March 1, 1996; 61(3): 834 - 839. [Abstract] [Full Text]
|
|
|
|
 |
|
 H. L. Lazar, C. Fitzgerald, S. Gross, T. Heeren, G. S. Aldea, and R. J. Shemin Determinants of Length of Stay After Coronary Artery Bypass Graft Surgery Circulation, November 1, 1995; 92(9): 20 - 24. [Abstract] [Full Text]
|
|
|
|
|
|
G. D. Buckberg Update on Current Techniques of Myocardial Protection Ann. Thorac. Surg., September 1, 1995; 60(3): 805 - 814. [Abstract] [Full Text]
|
|
|
|
|
|
W. R. Chitwood Jr, C. L. Wixon, T. O. Norton, and R. M. Lust Complex Valve Operations: Antegrade Versus Retrograde Cardioplegia? Ann. Thorac. Surg., September 1, 1995; 60(3): 815 - 818. [Abstract] [Full Text]
|
|
|
|
|
|
J. Caspi, E. Rudis, I. Bar, T. Safadi, and M. Saute Effects of Magnesium on Myocardial Function After Coronary Artery Bypass Grafting Ann. Thorac. Surg., April 1, 1995; 59(4): 942 - 947. [Abstract] [Full Text]
|
|
|
|
|
|
A. Cohen, M. Katz, R. Katz, E. Hauptman, and A. Schachner Chronic obstructive pulmonary disease in patients undergoing coronary artery bypass grafting J. Thorac. Cardiovasc. Surg., March 1, 1995; 109(3): 574 - 581. [Abstract] [Full Text]
|
|
|
|
|
|
O. Jegaden, A. Eker, P. Montagna, J. Ossette, C. Vial, J. Guidollet, and P. H. Mikaeloff Antegrade/Retrograde Cardioplegia in Arterial Bypass Grafting: Metabolic Randomized Clinical Trial Ann. Thorac. Surg., February 1, 1995; 59(2): 456 - 461. [Abstract] [Full Text]
|
|
|
|
|
|
W. R. Chitwood Jr and C. L. Wixon Update in Myocardial Protection Ann. Thorac. Surg., January 1, 1995; 59(1): 253 - 254. [Full Text]
|
|
|
|
|
|
B. W. Lytle, D. McElroy, P. McCarthy, F. D. Loop, P. C. Taylor, M. Goormastic, R. W. Stewart, and D. M. Cosgrove Influence of arterial coronary bypass grafts on the mortality in coronary reoperations J. Thorac. Cardiovasc. Surg., March 1, 1994; 107(3): 675 - 683. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
