Why the study?
Does combined antegrade and selective coronary graft cardioplegia reduce postoperative cardiac rhythm disturbances in right coronary artery occluded patients undergoing CABG?
Does combined antegrade and selective coronary graft cardioplegia reduce postoperative cardiac rhythm disturbances in right coronary artery occluded patients undergoing CABG?
Combined antegrade and selective right coronary graft cardioplegia significantly reduces hospital and ICU stay compared to antegrade and retrograde cardioplegia in RCA occluded patients undergoing CABG, though the reduction in rhythm disturbances was not statistically significant.
May shorten stays in RCA-occluded CABG; leaves open rhythm benefit and requires RCTs before practice change.
Aim: Post coronary artery bypass grafting (CABG) procedure conduction disturbances may appear due to many reasons. In this particular study we compared postoperative cardiac rhythm disturbances in right coronary artery (RCA) occluded patients, which cardioplegia disturbed with antegrade aortic and continuous retrograde way versus antegrade plus continue right coronary graft.Methods: A total of 104 patients with right coronary artery occlusion who underwent isolated CABG procedure between 2011 and 2017 were included. The number of female patients was 43 (41.4%). Left bundle branch, left branch hemi block, and left branch hemi block and 3rd degree atrioventricular (AV) blocks were evaluated in the early postoperative period.Results: The mean age of patients was 55.54±4.42 years (range 46-65 years). There was no statistical difference among groups according to preoperative and intraoperative demographics. Postoperative rhythm disturbances were higher in Group 1 but there was no statistical difference. (Group 1: 9 patients and Group 2: 4 patients. p=0.378). Hospital stay and intensive care unit (ICU) stay had statistically significant difference among groups (Group 1 mean hospital stay was 7.40±1.31 days and Group 2 had mean 6.53±1.19 days p=0.026 and Group 1 mean ICU stay was days 2.20±0.67 and Group 2 had mean 1.87±0.72 days p=0.021). Conclusion: We believe that continuous RCA-selective cardioplegia administration in addition to antegrade cardioplegia may be more successful in terms of prevention of postoperative rhythm disturbances in postoperative CABG applied patients.
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Uğur et al. (2018) studied this question.
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