Related Experiment Videos
Selective topical cooling for myocardial protection
T R McLean1, J W Jones, L G Svensson
1Cora and Webb Madding Department of Surgery, Baylor College of Medicine, Houston, Texas.
Cardiovascular Surgery (London, England)
|April 1, 1993
Summary
Selective topical myocardial cooling can be safely used during coronary artery bypass operations. This method avoids potential injuries associated with routine topical cooling, preserving red blood cells and protecting vital organs.
Area of Science:
- Cardiovascular Surgery
- Cardiac Anesthesia
- Myocardial Protection
Background:
- Antegrade infusion cardioplegia has limitations for myocardial cooling.
- Routine topical myocardial cooling can cause phrenic nerve, lung, and heart injury.
- Red blood cells are lost with irrigation fluid during topical cooling.
Purpose of the Study:
- To evaluate the selective use of topical myocardial cooling during coronary artery bypass operations.
- To determine if selective topical cooling can maintain myocardial temperatures effectively without routine application.
Main Methods:
- Prospective data collection from 67 patients undergoing isolated coronary artery bypass.
- Intramyocardial temperatures were measured after initial cardioplegia infusion.
- Patients were divided into two groups based on temperature: Group 1 (no topical cooling) and Group 2 (topical cooling if temperature > 20°C).
Main Results:
- No significant differences in patient demographics, risk factors, or surgical outcomes between groups.
- No deaths occurred in either group.
- Only one patient (3%) in the topical cooling group developed new Q waves.
Conclusions:
- Selective topical myocardial cooling is a safe and effective alternative to routine topical cooling.
- This approach minimizes potential complications and preserves valuable red blood cells.
- Further research may support the selective use of topical cooling in cardiac surgery.