Cold blood cardioplegia versus cold crystalloid cardioplegia: A prospective randomized study of 1440 patients undergoing coronary artery bypass grafting

Abstract

There were no significant differences whether myocardial protection was performed with cold blood cardioplegia or cold crystalloid cardioplegia during aortic crossclamping in patients undergoing coronary artery bypass grafting. The extra costs related to blood cardioplegia might be saved.

Cold blood versus cold crystalloid cardioplegia: a prospective randomised study of 345 aortic valve patients

“…In these series, first reported by Martin et al [14], who compared continuous warm blood cardioplegia and intermittent cold crystalloid cardioplegia in 1001 patients, the use of intra-aortic balloon pump (IABP) was similar in both arms of the study. This was also the fact in the study from our institution [4], comparing cold blood and cold crystalloid cardioplegia in 1440 CABG patients, seeing no significant differences in the use of either inotropic medication or IABP.…”

“…The results with clinical series have been more conflicting, mostly due to the small numbers of patients as well as heterogeneous techniques and operative procedures [2,3]. In the largest clinical trial so far, we were not able to demonstrate any differences in clinical outcome variables, comparing cold blood and cold crystalloid cardioplegia in patients undergoing coronary artery bypass grafting (CABG) [4]. Further, analysis of subgroups of patients with higher operative risk and those having the longest ischaemic arrest, could not reveal any differences in clinical outcome.…”

“…They found no differences in myocardial infarction and mortality, but claimed a significant lower incidence of low output syndrome (LOS) and CK-MB release with blood cardioplegia. However, theses conclusions are questionable, as no data on LOS were extracted from the two largest trials [4,14], which contributed to more than half of the patients in their review. In these series, first reported by Martin et al [14], who compared continuous warm blood cardioplegia and intermittent cold crystalloid cardioplegia in 1001 patients, the use of intra-aortic balloon pump (IABP) was similar in both arms of the study.…”

Myocardial damage following cardiac surgery: comparison between single-dose Celsior cardioplegic solution and cold blood multi-dose cardioplegia

“…[2][3][4][5] However, there are also studies suggesting that cold blood cardioplegia provides no better myocardial preservation than a cold crystalloid cardioplegic solution. 6,7 At the moment, no study has compared the Celsior solution with the cold blood solution in elective human valve operations. The Celsior cardioplegic solution is an extracellular-type, low-potassium, low-viscosity solution that includes many solutes, representing the most advanced concepts in organ preservation and, specifically, for heart transplantation ( Table 1).…”

The estimation of oxidative stress markers and apoptosis in right atrium auricles cardiomyocytes of patients undergoing surgical heart revascularisation with the use of warm blood cardioplegia.

“…There are numerous publications comparing blood and crystalloid cardioplegia [17][18][19][20][21]. Most of the authors claim that blood cardioplegia has better protective activity thanks to natural antioedematous, buffering and antioxidative properties.…”