Hemodynamics during First Hours after Surgery Using Cardiopulmonary Bypass - Crystalloid versus Blood Cardioplegia
BRÁT R., TOŠOVSKÝ J., DERYCH L., VELKOBORSKÝ S., ZEZULA R.
Kardiochirurgické centrum FNsP Ostrava, primář doc. MUDr. Jan Tošovský, CSc. |
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Summary:
We sought to determine if hemodynamic parameters after surgery using cardiopulmonary bypass are affected by the type of cardioplegic solution
used crystalloid or blood. Sixty patients with left ventricle ejection fraction < 35 % scheduled for coronary artery bypass surgery were randomized
into two groups. In the first group cold blood cardioplegia was used, in the other cold crystalloid cardioplegia was used. We collected hemodynamic
data before the procedure and at one, two, four and six hours after weaning from cardiopulmonary bypass, and on the first postoperative day. We also
collected clinical data reflecting perioperative myocardial preservation.
No patient died in any group. We did not find significant difference between the incidence of perioperative myocardial infarction, arrhythmia and
the need for intraaortic balloon pump use in the postoperative period. In the early postoperative course we found significantly better hemodynamic
data in the group with blood cardioplegia (LVSWI, RVSWI).
Blood cardioplegia ensured better perioperative myocardial preservation which resulted in faster restoration of myocardial functions. This difference
could be of significance in patients with severe dysfunction of the left ventricle.
Key words:
cardioplegia - hemodynamics - coronary artery bypass surgery - dysfunction
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