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A comparison between ischemic preconditioning, intermittent cross-clamp fibrillation and cold crystalloid cardioplegia for myocardial protection during coronary artery bypass graft surgery

Teoh, LKK; Grant, R; Hulf, JA; Pugsley, WB; Yellon, DM; (2002) A comparison between ischemic preconditioning, intermittent cross-clamp fibrillation and cold crystalloid cardioplegia for myocardial protection during coronary artery bypass graft surgery. CARDIOVASC SURG , 10 (3) 251 - 255.

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Abstract

The aim of this study was to compare ischemic preconditioning (IPC) with two established methods of myocardial protection, namely cold crystalloid cardioplegia and intermittent cross-clamp fibrillation (ICCF), in coronary artery bypass graft (CABO) surgery. This was a prospective randomised study. Thirty CABO patients were randomised to receive: (a) St Thomas' cardioplegia solution no. 2; (b) ICCF; or (c) IPC (two 3-min periods of ischemia with 2-min of reperfusion). Surgery was performed under standardised conditions by one surgeon (WBP). The primary endpoint was cardiac troponin T release during the first 72 h after surgery. Mean troponin T at 72 h was significantly lower in the IPC group (0.5 mug/l; p=0.05, ANOVA) compared with the cardioplegia and ICCF groups (2.1 and 1.3 mug/l respectively). This suggests that ischemic preconditioning is superior at limiting myocardial necrosis during CABO, but there is no difference between cold crystalloid cardioplegia and intermittent cross-clamp fibrillation. (C) 2002 Published by Elsevier Science Ltd on behalf of The International Society for Cardiovascular Surgery.

Type:Article
Title:A comparison between ischemic preconditioning, intermittent cross-clamp fibrillation and cold crystalloid cardioplegia for myocardial protection during coronary artery bypass graft surgery
Keywords:myocardial protection, cardiac surgery, preconditioning, BLOOD CARDIOPLEGIA, RANDOMIZED TRIAL, POTASSIUM, RELEASE, ARREST
UCL classification:UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science

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