[Comparison between intermittent retrograde cold blood cardioplegia and retrograde crystalloid cardioplegia]

Intermittent retrograde cold blood cardioplegia was compared with retrograde crystalloid cardioplegia. Twenty-two adult patients underwent open heart surgery divided into two groups. Group BCP (n = 10) was protected with 15 degrees C blood containing potassium 15 mEq/l; Group CCP (n = 12) was protected with 4 degrees C St. Thomas' Hospital cardioplegic solution. Lactate, pyruvate, and CK-MB levels in coronary sinus blood were measured at 5 and 15 minutes after aortic unclamping and 5 minutes after weaning from cardiopulmonary bypass (CPB) in both groups. CPB time, cross-cross clamp time, incidence of postoperative low output syndrome and spontaneous return to sinus rhythm after aortic unclamping were not different between two groups. Cardiac index and pulmonary capillary wedge pressure measured immediately after weaning from CPB, were not different in both groups. Lactate level was significantly low in group BCP. Lactate uptaking ratio of myocardium was significantly high in group BCP. CK-MB levels were not different between two groups. Cold blood cardioplegia was seemed to provide better aerobic myocardial metabolism during aortic cross clamp. However, CK-MB levels and hemodynamic studies were not different.