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Conduction disturbances after blood and crystalloid cardioplegia in coronary bypass surgery

E J Pehkonen1, T T Rinne, P J Mäkynen

  • 1Department of Surgery, Tampere University Hospital, Finland.

Scandinavian Journal of Thoracic and Cardiovascular Surgery
|January 1, 1993
PubMed

Insights

Postoperative conduction disturbances after coronary artery bypass grafting were transient in most patients. Myocardial ischemia was a key factor, with prior heart attack and right coronary artery stenosis increasing risk for heart block.

Area of Science:

  • Cardiology
  • Cardiac Surgery

Background:

  • Postoperative conduction disturbances can occur after coronary artery bypass grafting (CABG).
  • The type of cardioplegia used may influence the incidence of these disturbances.

Purpose of the Study:

  • To analyze the incidence and determinants of postoperative conduction disturbances following CABG.
  • To compare the effects of blood versus crystalloid cardioplegia on conduction disturbances.

Main Methods:

  • A randomized study of 100 patients undergoing CABG.
  • Patients received either blood cardioplegia or crystalloid cardioplegia.
  • Conduction disturbances were monitored post-cardiopulmonary bypass.

Main Results:

  • Conduction disturbances occurred in 30% of patients, primarily transient.
  • There was no significant difference in incidence between blood and crystalloid cardioplegia groups (15 patients each).
  • Myocardial ischemia was identified as a major determinant.

Conclusions:

  • Transient conduction disturbances are common after CABG.
  • Ischemia is a significant risk factor for these disturbances.
  • Previous myocardial infarction and right coronary artery stenosis increase the risk of right bundle branch block.

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