What question did this study set out to answer?

This research aims to compare postoperative outcomes between intermittent antegrade cardioplegia and combined antegrade/retrograde cardioplegia.

March 30, 2026Open Access

Comparison of intermittent antegrade cardioplegia and antegrade/retrograde cardioplegia in cardiac surgery: A propensity-matched analysis

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Cardiac surgery (n=915). Intervention: Intermittent antegrade cardioplegia vs. Intermittent antegrade and continuous retrograde cardioplegia. Primary outcome: Mortality (propensity-matched) (p=0.08).

Key Result

Intermittent antegrade cardioplegia alone yielded similar postoperative outcomes, including mortality (11.6% vs 7.4%, p=0.08), compared to combined antegrade and continuous retrograde cardioplegia.

Key Points

This research aims to compare postoperative outcomes between intermittent antegrade cardioplegia and combined antegrade/retrograde cardioplegia.
Conducted a propensity-matched analysis to compare two cardioplegia methods.
Focused on outcomes in cardiac surgery patients.
Identified key postoperative results from both strategies.
Intermittent antegrade cardioplegia alone showed similar postoperative outcomes to combined cardioplegia.
No significant differences were noted in recovery metrics between the two approaches.

Study Design

Type

Observational (n=915)

Multicenter

Structured PICO

Does intermittent antegrade cardioplegia alone yield similar postoperative outcomes compared to combined antegrade and continuous retrograde cardioplegia in patients undergoing cardiac surgery?

Population

Adults over 18 years old undergoing cardiac surgery (excluding beating heart and non-blood cardioplegia), mean age 59, 70.8% male.

Intervention

Intermittent antegrade cardioplegia alone (initial dose 10 mL/kg, maintenance 5 mL/kg at 20-30 min intervals).

Comparator

Intermittent antegrade cardioplegia combined with continuous retrograde cardioplegia via the coronary sinus.

Outcome

Postoperative clinical outcomes (including mortality, ICU stay, hospital stay, and myocardial injury markers).

Intermittent antegrade cardioplegia alone provides comparable myocardial protection and clinical outcomes to the combined antegrade/retrograde approach in cardiac surgery.

Main Result

Absolute Event Rate: 11.6% vs 7.4%

p-value: p=0.08

Limitations

Retrospective and single-centered design
No comparison regarding patients using multiport
Heterogeneous group including all cardiac surgical procedures, not just isolated CABG
Echocardiographic findings limited to the first postoperative week
Degree of coronary lesions could not be evaluated
No comparison regarding aortic clamping techniques

Abstract

This propensity-matched study supports that intermittent anterograde cardioplegia alone can yield similar postoperative outcomes compared to the combined strategy.

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Cite This Study

Beyazal et al. (Fri,) conducted a observational in Cardiac surgery (n=915). Intermittent antegrade cardioplegia vs. Intermittent antegrade and continuous retrograde cardioplegia was evaluated on Mortality (propensity-matched) (p=0.08). Intermittent antegrade cardioplegia alone yielded similar postoperative outcomes, including mortality (11.6% vs 7.4%, p=0.08), compared to combined antegrade and continuous retrograde cardioplegia.

synapsesocial.com/papers/69ca12d4883daed6ee095113 https://doi.org/https://doi.org/10.4274/tjtcs.2026.28228