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Brazilian Journal of Cardiovascular Surgery

Print version ISSN 0102-7638

Abstract

COSTA, Potiguara S. da et al. Oxygenated cardioplegia in myocardial protection during cardiac surgery: a clinical and enzymatic study. Rev Bras Cir Cardiovasc [online]. 1988, vol.3, n.3, pp.210-215. ISSN 0102-7638.  http://dx.doi.org/10.1590/S0102-76381988000300009.

Cardioplegia has been recognized as a very important factor in myocardial protection. Today we know that even the arrested heart at 15ºC wastes oxygen. "In vitro" it was already shown that release of oxygen was higher in cristalloid than in blood solution. In this study we analized the hemodinamic, electrocardiographic and enzimatic variations in 26 patients, divided into two groups in whom cardioplegia with the Gomes solution was used. Group I: 12 patients (control group - non oxygenated solution). Grupo II: 14 patients (oxygenated solution). The evaluation of the patients included hemodynamic recovery after arrest, the use of vasoactive drugs, cardiac rhythm and aspect of the ECG, heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP) and enzymes SGOT and CPK-MB in the following times: pre and postoperatory period and after 6, 12, 24, 48 and 72 hours of postoperatory period. Hemodynamic recovery was similar in both groups, the use of vasoactive drugs was greater in Group II. In the ECG was seen more sinus bradycardia in Group II that also needed more electric defibrilation. Heart rate, mean arterial prossure and central venous pressure showed no significant difference between the two groups in the postoperative period. The enzymes SGOT and CPK were higher in Group I than in Group II. In conclusion, data suggested that both solutions had similar results in the hemodynamic recovery end vital parameters. An higher incidence of bradycardia was seen in Group II, probably related to the longer cardiac arrest, with more infusions of the cardioplegic solution. The variation of the enzimes suggested that oxygenated cardioplegia was more effective than the non-oxygenated solution to assure the preservation of the myocardium.

Keywords : myocardial protection [cardioplegia].

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