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The Journal of Thoracic and Cardiovascular Surgery, Vol 74, 900-906, Copyright © 1977 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Cold cardioplegia or continuous coronary perfusion? Report on preliminary clinical experience as assessed cytochemically

MV Braimbridge, J Chayen, L Bitensky, DJ Hearse, P Jynge and S Cankovic-Darracott

Myocardial preservation by continuous coronary perfusion is compared with cold cardioplegia. The 1 L. of St. Thomas' cardioplegic protective solution used for infusion into the coronary arteries was at 4 degrees C. and had a normal electrolyte content except for raised concentrations of magnesium and potassium and the addition of procaine. Myocardial preservation was assessed by cytochemical grading of myocardial biopsy specimens and also by the requirement for significant inotropic support postoperatively. In aortic valve replacements with an aortic occlusion time of 1 1/2 hours, both techniques afforded a similar degree of preservation, except that the inner half of the myocardium was markedly better preserved by cold cardioplegia. After 2 hours in double valve replacements, a single cardioplegic infusion was not as effective as continuous coronary perfusion, but this could be corrected by a second infusion of the cardioplegic solution after an hour.

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