Comparison between intermittent antegrade warm blood cardioplegia and cold crystalloid cardioplegia in patients performed reoperation for valvular heart disease

The purpose of this study was to compare the postoperative cardiac function and systemic effects between intermittent antegrade warm blood cardioplegia and cold crystalloid cardioplegia in patients performed reoperation for chronic acquired valvular heart disease. Group I consisted of 4 patients who underwent intermittent antegrade warm blood cardioplegia (MVR in 1, MVR + TAP in 2, DVR + TAP in 1), and Group II consisted of 5 patients who underwent intermittent antegrade cold crystalloid cardioplegia (MVR + TAP in 3, TVR in 2). There were no significant differences found between the two groups in operation time, perfusion time, aortic cross clamp time, spontaneous beating rate after declamping and reperfusion time. Also doses of inotropes required during weaning was almost the same for the both groups. But 24 hours after surgery, smaller doses of inotropes (4.4 +/- 2.1 gamma/kg/min) were required for Group 1, while larger doses (7.8 +/- 2.8 gamma/kg/min) were required for Group 2 (p < 0.05). As for the postoperative complications, none was noted in Group 1, while multiple organ failure in 2, hyperbilirubinemia in 2 and complete atrioventricular block in 1 patient was noted in Group 2. The above results suggest that, for reoperations of valvular heart disease, intermittent antegrade warm blood cardioplegia is a useful and reliable method with optimum myocardial protection as well as favorable systemic effects.