Key result
Cold cardioplegia provided equal myocardial protection to intermittent ischaemic arrest despite a significantly longer cross-clamp time, implying greater overall protection.
Why the study?
Does cold cardioplegia with external cardiac cooling improve myocardial preservation compared to intermittent ischaemic arrest in patients undergoing coronary bypass surgery?
RCT (n=50)
randomly assigned
Does cold cardioplegia with external cardiac cooling improve myocardial preservation compared to intermittent ischaemic arrest in patients undergoing coronary bypass surgery?
Cold cardioplegia allows for significantly longer cross-clamp times while providing equal myocardial protection compared to intermittent ischemic arrest during coronary bypass surgery.
Enables longer cross-clamp times with equivalent myocardial protection in CABG; confirms overall advantage of cold cardioplegia.
No definitive method of myocardial preservation has been established and conclusions based on experimental data may not be applicable to patients with coronary artery disease. Fifty patients undergoing coronary bypass grafting were randomly assigned to one of two groups for myocardial preservation. In group A cold cardioplegia with external cardiac cooling was used and in group B ischaemic arrest with mild systemic cooling to 32 degrees C. Myocardial preservation was assessed by analysis of enzymes specific to the heart, left ventricular biopsy, and electrocardiography. Equal protection of the myocardium was provided in both groups but the mean cross-clamp time in group A was significantly longer than in group B. This implies that cardioplegia confers greater protection than intermittent ischaemic arrest.
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Pepper et al. (1982) conducted an RCT in coronary artery disease (n=50). Cold cardioplegia with external cardiac cooling vs. Ischaemic arrest with mild systemic cooling to 32 degrees C was evaluated on Myocardial preservation assessed by heart-specific enzymes, left ventricular biopsy, and electrocardiography. Cold cardioplegia provided equal myocardial protection to intermittent ischaemic arrest despite a significantly longer cross-clamp time, implying greater overall protection.
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