Myocardial protection in coronary artery bypass surgery. A study comparing cold cardioplegia and intermittent aortic...

Twenty patients having elective coronary artery bypass surgery were randomized for myocardial protection during cardiopulmonary bypass with cold cardioplegia and topical deep hypothermia with the Bretschneider solution in one group and intermittent aortic cross clamping at 30 degrees C in another group. The cardioplegic group showed more consistent results with lower CK-MB elevations both in terms of peak values and areas under the time-enzyme activity curves, although no statistical significance was obtained. There were significantly more infarct suspect time-enzyme activity curves in the intermittent cross clamping group (4 vs. O), and therefore, cold cardioplegia is advocated in preference to intermittent cross clamping in coronary artery bypass surgery.