Comparison Of Antegrade And Antegrade/Retrograde Blood Cardioplegia Applications In Cardiopulmonary Bypass Accompanıed Cardiac Surgery

Abstract

Introduction: Ischemic heart disease (IHD) is among the leading causes of death worldwide. Sometimes, cardiopulmonary bypass (CPB) is inevitable in the treatment of heart diseases by open heart surgery procedures. Myocardium protection is of great importance in CPB cases. Various techniques and applications exist for the protection of the myocardium.
 Objective: In this study, it was aimed to determine the perioperative and postoperative early outcomes of coronary artery bypass grafting (CABG) operations with CPB by comparing intermittent antegrade and intermittent antegrade (Initial) combined with retrograde (Maintenance) blood cardioplegia applications.
 Materials and Methods: 240 patients with similar characteristics who underwent CPB-guided CABG operation were included. Two groups were formed as Antegrade (Group 1) and Antegrade/retrograde (Group 2). The preoperative, intraoperative, and early postoperative results of the groups were compared.
 Results: Gender, age, body surface area, flow, ejection fraction percentages, EuroSCORE and LMCA lesion presence values were similar in both groups (p>0.05). Cross-clamp time, total perfusion time, mean activated clotting time during CPB and perioperative drainage were similar in both groups (p>0.05). There was no statistically significant difference between the sodium, potassium, calcium, glucose, and lactate levels evaluated after CPB of the two groups (p>0.05). In addition, there was no statistically significant difference between the two groups in terms of defibrillation requirement, inotropic requirement, and IABP requirement after CPB. (p>0.05).
 Conclusion: Similar results were observed between antegrade cardioplegia alone and antegrade combined with retrograde cardioplegia in CPB-guided CABG operations. For this reason, we think that the antegrade cardioplegia technique alone will be more advantageous in terms of ease of application, not requiring additional invasive intervention, and eliminating the risks of the necessity of additional intervention. Furthermore, we think that the importance of case-based evaluation in cardioplegia techniques should not be ignored.