The Journal of Thoracic and Cardiovascular Surgery
Volume 139, Issue 4 , Pages 874-880 , April 2010

Cold blood cardioplegia reduces the increase in cardiac enzyme levels compared with cold crystalloid cardioplegia in patients undergoing aortic valve replacement for isolated aortic stenosis

  • Bjørn Braathen, MD
    • ,
  • Theis Tønnessen, MD, PhD

      Affiliations

    • Corresponding Author InformationAddress for reprints: Theis Tønnessen, MD, PhD, Department of Cardiothoracic Surgery, Ullevål University Hospital, and University of Oslo, Oslo, Norway.

Received 16 March 2009 ,Revised 26 April 2009 ,Accepted 31 May 2009.

References 

  1. Axford-Gatley RA, Wilson GJ, Feindel CM. Comparison of blood-based and asanguineous cardioplegic solutions administered at 4 degrees C. An ultrastructural morphometric study in the dog. J Thorac Cardiovasc Surg. 1990;100:400–409
  2. Barner HB. Blood cardioplegia: a review and comparison with crystalloid cardioplegia. Ann Thorac Surg. 1991;52:1354–1367
  3. Catinella FP, Cunningham JN, Spencer FC. Myocardial protection during prolonged aortic cross-clamping. Comparison of blood and crystalloid cardioplegia. J Thorac Cardiovasc Surg. 1984;88:411–423
  4. Feindel CM, Tait GA, Wilson GJ, Klement P, MacGregor DC. Multidose blood versus crystalloid cardioplegia. Comparison by quantitative assessment of irreversible myocardial injury. J Thorac Cardiovasc Surg. 1984;87:585–595
  5. Guru V, Omura J, Alghamdi AA, Weisel R, Fremes SE. Is blood superior to crystalloid cardioplegia? A meta-analysis of randomized clinical trials. Circulation. 2006;114(suppl):I331–I338
  6. Jacob S, Kallikourdis A, Sellke F, Dunning J. Is blood cardioplegia superior to crystalloid cardioplegia?. Interact Cardiovasc Thorac Surg. 2008;7:491–498
  7. Ovrum E, Tangen G, Tollofsrud S, Oystese R, Ringdal MA, Istad R. Cold blood cardioplegia versus cold crystalloid cardioplegia: a prospective randomized study of 1440 patients undergoing coronary artery bypass grafting. J Thorac Cardiovasc Surg. 2004;128:860–865
  8. Braathen B, Vengen OA, Tonnessen T. Myocardial cooling with ice-slush provides no cardioprotective effects in aortic valve replacement. Scand Cardiovasc J. 2006;40:368–373
  9. Jaffe AS, Babuin L, Apple FS. Biomarkers in acute cardiac disease: the present and the future. J Am Coll Cardiol. 2006;48:1–11
  10. Larstorp AC, Lund SC, Tonnessen T, Muller C, Kjeldsen SE, Mangschau A. Scintigraphic demonstration of myocardial perfusion and ischaemia associated with coronary artery bypass grafting. Scand Cardiovasc J. 2006;40:354–362
  11. Calafiore AM, Teodori G, Di GG, Bosco G, Mezzetti A, Lapenna D, et al. Intermittent antegrade cardioplegia: warm blood vs cold crystalloid. A clinical study. J Cardiovasc Surg (Torino). 1994;35:179–184
  12. Daggett WM, Randolph JD, Jacobs M, O'Keefe DD, Geffin GA, Swinski LA, et al. The superiority of cold oxygenated dilute blood cardioplegia. Ann Thorac Surg. 1987;43:397–402
  13. Kaul TK, al KR, Sharif H, Ramsdale DR. Results of combined valve replacement and myocardial revascularization. Relation to method of myocardial protection. J Cardiovasc Surg (Torino). 1989;30:322–327
  14. Loop FD, Higgins TL, Panda R, Pearce G, Estafanous FG. Myocardial protection during cardiac operations. Decreased morbidity and lower cost with blood cardioplegia and coronary sinus perfusion. J Thorac Cardiovasc Surg. 1992;104:608–618
  15. Brat R, Tosovsky J, Januska J, Derych L, Velkoborsky S, Bruk V, et al. Comparison between blood and crystalloid cardioplegia in patients with left ventricular dysfunction undergoing coronary surgery. Acta Medica (Hradec Kralove). 2000;43:107–110
  16. Christakis GT, Fremes SE, Weisel RD, Madonik MM, McDonough JH, Tittley JG, et al. Reducing the risk of urgent revascularization for unstable angina: a randomized clinical trial. J Vasc Surg. 1986;3:764–772
  17. Fremes SE, Christakis GT, Weisel RD, Mickle DA, Madonik MM, Ivanov J, et al. A clinical trial of blood and crystalloid cardioplegia. J Thorac Cardiovasc Surg. 1984;88:726–741
  18. Ibrahim MF, Venn GE, Young CP, Chambers DJ. A clinical comparative study between crystalloid and blood-based St Thomas' hospital cardioplegic solution. Eur J Cardiothorac Surg. 1999;15:75–83
  19. Caputo M, Dihmis W, Birdi I, Reeves B, Suleiman MS, Angelini GD, et al. Cardiac troponin T and troponin I release during coronary artery surgery using cold crystalloid and cold blood cardioplegia. Eur J Cardiothorac Surg. 1997;12:254–260
  20. Hendrikx M, Jiang H, Gutermann H, Toelsie J, Renard D, Briers A, et al. Release of cardiac troponin I in antegrade crystalloid versus cold blood cardioplegia. J Thorac Cardiovasc Surg. 1999;118:452–459
  21. Martin TD, Craver JM, Gott JP, Weintraub WS, Ramsay J, Mora CT, et al. Prospective, randomized trial of retrograde warm blood cardioplegia: myocardial benefit and neurologic threat. Ann Thorac Surg. 1994;57:298–302
  22. Young JN, Choy IO, Silva NK, Obayashi DY, Barkan HE. Antegrade cold blood cardioplegia is not demonstrably advantageous over cold crystalloid cardioplegia in surgery for congenital heart disease. J Thorac Cardiovasc Surg. 1997;114:1002–1008
  23. Bouchart F, Bessou JP, Tabley A, Hecketsweiller B, Mouton-Schleifer D, Redonnet M, et al. How to protect hypertrophied myocardium? A prospective clinical trial of three preservation techniques. Int J Artif Organs. 1997;20:345–351
  24. Jin XY, Gibson DG, Pepper JR. Early changes in regional and global left ventricular function after aortic valve replacement. Comparison of crystalloid, cold blood, and warm blood cardioplegias. Circulation. 1995;92(suppl):II155–II162
  25. Nesher N, Alghamdi AA, Singh SK, Sever JY, Christakis GT, Goldman BS, et al. Troponin after cardiac surgery: a predictor or a phenomenon?. Ann Thorac Surg. 2008;85:1348–1354
  26. Lehrke S, Steen H, Sievers HH, Peters H, Opitz A, Muller-Bardorff M, et al. Cardiac troponin T for prediction of short- and long-term morbidity and mortality after elective open heart surgery. Clin Chem. 2004;50:1560–1567

 Supported by the Ingegerd and Viking Olov Björk Scholarship received by Dr Tønnessen.

 Disclosures: None.

PII: S0022-5223(09)00814-9

doi: 10.1016/j.jtcvs.2009.05.036

The Journal of Thoracic and Cardiovascular Surgery
Volume 139, Issue 4 , Pages 874-880 , April 2010

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