Abstract
Ventricular fibrillation seen just after declamping of the aorta is an undesirable condition causing myocardial injury. To return to normal rhythm, often internal shocks are applied. But defibrillation itself can also contribute to myocardial injury. So prevention of fibrillation is more important than treatment. 236 patients undergoing coronary artery by-pass surgery were included in this retrospective clinical study. 144 of those patients were operated using modified St. Thomas’ Hospital cardioplegic solution, for stopping the heart. In the other 92 patients, plegisol cardioplegic solution was used. We compared the two groups for the development of ventricular fibrilation after declamping of the aorta. In the modified St. Thomas’ Hospital group, ventricular fibrillation after declamping of the aorta was seen less frequently, this being statistically significant (22.2% vs. 52.2%, p = 0.026). This study shows that the modified St.Thomas’ Hospital cardioplegic solution is preferred for avoiding ventricular fibrillation occuring just after declamping of the aorta.
Highlights
In open heart surgery, ventricular fibrillation appearing just after declamping of the aorta is a common, severe energy spending situation
Two of the more common types of cardioplegic solutions formulated with different concentrations of electrolytes and antiarrythmic agents have been used in cardiac surgery
We aimed to investigate whether there is a difference between two cardioplegic solutions, Plegisol and modified St Thomas’ Hospital, in the frequency of ventricular fibrillation occurence after declamping of the aorta
Summary
Ventricular fibrillation appearing just after declamping of the aorta is a common, severe energy spending situation. That is why the heart must be defibrillated immediately. Prevention of ventricular fibrillation is more important than its treatment for avoiding some adverse outcomes. Cardioplegic solutions used to stop the heart during distal anastomosis, for drying of the operative field, have been further improved to produce better outcomes. Two of the more common types of cardioplegic solutions formulated with different concentrations of electrolytes and antiarrythmic agents have been used in cardiac surgery. We aimed to investigate whether there is a difference between two cardioplegic solutions, Plegisol and modified St Thomas’ Hospital, in the frequency of ventricular fibrillation occurence after declamping of the aorta.
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