Why the study?
Does retrograde application of Bretschneider cardioplegia improve myocardial preservation compared to antegrade application in patients undergoing aortocoronary bypass surgery?
Does retrograde application of Bretschneider cardioplegia improve myocardial preservation compared to antegrade application in patients undergoing aortocoronary bypass surgery?
Retrograde application of Bretschneider cardioplegia provides superior myocardial protection by preventing the catabolism of energy-rich phosphates compared to antegrade application during aortocoronary bypass surgery.
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Supports retrograde Bretschneider cardioplegia for myocardial protection in CABG; confirms energy preservation superiority over antegrade in this RCT.
The efficacy of myocardial protection obtained by antegrade application of a cardioplegic solution was compared with that obtained by retrograde application via the coronary sinus. Myocardial preservation was assessed using biochemical parameters, i.e. tissue content of lactate, creatine phosphate, nucleotides, nucleosides and hypoxanthine. Nineteen patients undergoing routine aortocoronary bypass surgery were randomly allocated to a study group. During cardiac arrest induced by antegrade Bretschneider cardioplegia, myocardial tissue content of creatine phosphate dropped to 52% of its pre-ischemic value and degradation of nucleotides occurred, characterized mainly by an accumulation of adenosine. Retrograde cardioplegia prevented this catabolism of energy-rich phosphates completely during ischemic cardiac arrest and is therefore considered to be superior to antegrade cardioplegia.
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Walter et al. (1988) studied this question.
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