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European Journal of Cardio-Thoracic Surgery, Vol 7, 623-627, Copyright © 1993 by European Association for Cardio-thoracic Surgery
M Tonz, T Mihaljevic, M Pasic, LK von Segesser and M Turina
To evaluate the effects of temperature on myocardial and total body
protection, we analyzed 129 consecutive patients who underwent coronary
artery bypass grafting, valve replacement, or both, with continuous
cardioplegia (Cp). The patients were assigned to three groups: group I (n =
37) normothermic cardiopulmonary bypass (CPB) (37 degrees C) and warm (37
degrees C) Cp, group II (n = 49) normothermic CPB and cold (4 degrees C) Cp
and group III (n = 43) hypothermic (28 degrees C) CPB and cold Cp.
Comparison of groups I and II showed similar serum levels of creatine
kinase (CK) and its myocardial-specific isoenzyme on the first
postoperative day, a similar rate of perioperative myocardial infarction,
postoperative need for intra-aortic balloon pump, postoperative need for
inotropic support and mortality. Comparison of groups I and III showed
similar serum levels of CK, amylase, lactate dehydrogenase and creatinine
on the first postoperative day, a similar complication rate and mortality
rate. However, normothermic CPB resulted in a shorter bypass time (83 +/- 4
vs 98 +/- 7 min, P < 0.05) and interval until extubation (25.0 +/- 3.8
vs 40.3 +/- 7.4 h, P < 0.05). In conclusion, there are no differences
concerning myocardial protection, however, warm CPB shortens the perfusion
time and postoperative course.
ARTICLES
The warm versus cold perfusion controversy: a clinical comparative study
Clinic for Cardiovascular Surgery, University Hospital, Zurich, Switzerland.
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