MYOCARDIAL PROTECTION: A CLINICAL COMPARISON OF COLD BLOOD CARDIOPLEGIA AND COLD CRYSTALLOID CARDIOPLEGIA

Objective: To assess the clinical outcome of two groups of patients by using cold blood cardioplegia and cold crystalloid cardioplegia for myocardial protection in open heart surgical cases.Material and Methods: This study was conducted from July 1993 to Dec 2004. Clinical data was retrieved from hospital records of the patients who underwent any open heart surgery. Patients were divided into two groups. Group A: included patients treated from July 1993 to December 2002, and cold crystalloid cardioplegia was used. Group B: included patients operated from Jan 2003 to Dec 2004, and cold blood cardioplegia was used for myocardial protection. Data was analyzed in both groups by using Chi Square test.Results: There was no significant difference in terms of cross clamp time, bypass time in the two groups. Spontaneous recovery of cardiac rhythm after declamping was 19.39% in Group A and 72% in Group B. Need for electrical cardioversion after declamping in Group A was 12% and 18% in Group B. The incidence of post clamp ventricular fibrillation was 18.85% in Group A and 7.27% in Group B. Operative mortality was 6.06% in Group A and 4.84% in Group B. Mean duration of mechanical ventilatory support was 16.42 hours in Group A and 5.59 hours in Group B. Mean duration of inotropic support to keep systolic blood pressure >100 mmHg was 31 hours in Group A and 10 hours in Group B.Conclusion: Cold blood cardioplegia provides a better myocardial protection as compared to cold crystalloid cardioplegia.