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Changes of biventricular function after CABG surgery: does cardioplegia type matter?

Rasa Ordienė1, Ramūnas Unikas1, Agnė Abramavičiūtė1

  • 1Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Perfusion
|September 10, 2020
PubMed

Insights

The type of cardioplegia used during coronary artery bypass grafting (CABG) impacts biventricular function. Buckberg cardioplegia (BC) demonstrates superior right ventricular reverse remodeling and improved function compared to crystalloid cardioplegia (CC) post-CABG.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Cardioplegia Research

Background:

  • Coronary artery bypass grafting (CABG) is a common cardiac procedure.
  • The choice of cardioplegia solution can influence myocardial protection and postoperative cardiac function.
  • Biventricular function assessment is crucial for predicting outcomes after cardiac surgery.

Purpose of the Study:

  • To evaluate whether the type of cardioplegia administered during CABG surgery is a significant predictor of biventricular function changes.
  • To compare the effects of crystalloid cardioplegia (CC) versus Buckberg cardioplegia (BC) on cardiac geometry and function post-CABG.

Main Methods:

  • A prospective study involving 81 patients undergoing CABG, excluding those with acute MI, impaired LV function, or atrial fibrillation.
  • Transthoracic echocardiography (TTE) assessed biventricular parameters pre-operatively, on postoperative day 1, and at 6 months.
  • Patients were randomized into two groups: CC (n=49) and BC (n=32).

Main Results:

  • The BC group showed significantly better right ventricular (RV) reverse remodeling, including reduced RV and right atrial diameters, and improved longitudinal RV function (TAPSE, RV S') at 6 months.
  • RV global systolic function diminished postoperatively in both groups, with a greater reduction in the CC group.
  • Left ventricular (LV) systolic function and left atrial diameter changes did not differ between groups, but LV diastolic function improved significantly in the BC group at 6 months (decreased E/e', augmented septal e').

Conclusions:

  • Buckberg cardioplegia (BC) is associated with favorable RV reverse remodeling and enhanced longitudinal RV function following CABG surgery.
  • BC also contributes to improved left ventricular diastolic function at the late follow-up period after CABG.
  • The type of cardioplegia is an important factor influencing biventricular recovery and remodeling post-CABG.
Abstract

Keywords:
biventricular functionblood cardioplegiacoronary artery bypass graftingcrystalloid cardioplegia

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