Study of different delivered methods of cardioplegia in coronary artery bypass graft

Objective：To study the affection of perfusion of cardioplegic solution with blood on cardiopulmonary bypass （CPB） and postoperative recover.Methods：182patients underwent simple coronary artery bypass graft （CABG） were divided into 4 groups according to the ways of cardioplegia delivery.Group 1：antegrade perfusion （n=57）；Group 2：combined antegrade and graftgrade perfusion （n= 41）；Group 3：combined both perfusion （n=10）；Group 4：combined antegrade and retrograde and graftgrade perfusion（n=74）.Sorin BCD were used in all patients.4：1cool cardioplegic solution with blood was delivered interruptedly or continuously.To compare the 4 groups in clinical materials，the CPB and the aortic clamp time，the lowest temperature，heamodilusion degree，rate of dopamine requirements and IABP usage，duration of respirator ventilation after operation and days in ICU，postoperative heart function and ejection fraction （EF）.Results：There were no significant difference（P＞0.05）among 4 groups in age，weight，pre-operative heart function and EF， quantity of vessel coronary artery disease，duration of respirator ventilation and ICU days，post-operative heart function and EF，rate of dopamine requirements and IABP usage.There were positive correlation between quantity of CABG，rate of dopamine support and CPB time， aortic clamp time （P＜0.01）.In group 4：CPB time，aortic clamp time，the lowest nasopharynx and anal temperature were significantly longer and lower（P＜0.01）than group 1 and 2；heamodilution was significantly higher（P＜0.05）than the group 1；the rate of auto-resuscitation was the lowest（P＜0.05）.The postoperative heart function increased in all groups（P＜0.01）.The postoperative EF decreased significantly compared with preoperative （P＜0.01） except group 3.Conclusion：All the four methods can get the good results of myocardium protection.Our data show that the interrupted antegrade perfusion was the most safety and convenient technique in shortening the CPB and aortic clamp time and reducing the operative risk in patients of simple CABG.