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  • Title: Does combination of antegrade and retrograde cardioplegia reduce coronary artery bypass grafting-related conduction defects?
    Author: Bolcal C, Emrecan B, Bingöl H, Ayik MF, Cingöz F, Yildirim V, Kuralay E, Demirkiliç U, Kiliç S, Tatar H.
    Journal: Heart Surg Forum; 2006; 9(6):E866-70. PubMed ID: 17060042.
    Abstract:
    BACKGROUND: Conduction disorders appearing after coronary artery bypass surgery (CABG) may have many different causes. In this study, we evaluated the postoperative conduction disorders after CABG with respect to the ante-grade blood cardioplegia and ante-grade plus continuous retrograde cardioplegia delivery methods. MATERIALS AND METHODS: This retrospective study included 1824 patients undergoing CABG between January 2001 and December 2005. There were 694 female patients (38%) and 1130 male patients (62%). Myocardial protection was done by isothermic hyperkalemic blood cardioplegia. Patents in Group 1 (n = 704) were operated on using only intermittent antegrade cardioplegia and those in group 2 (n = 1120) were operated on using the antegrade plus retrograde continuous cardioplegia. The postoperative occurrences of a new right bundle branch block, left anterior hemiblock, left posterior hemiblock, left bundle branch block, or third-degree atrioventricular block were evaluated and compared. RESULTS: Total mortality rate was 1.6% (29 patients) without significant difference between the groups. The preoperative and perioperative characteristics were statistically similar in the groups. The occurrence of conduction disorders was significantly higher in group 1 (P = .006, 55 versus 52 patients). The analysis of the patients with conduction disorders showed a significantly increased mortality rate (P < .001) in addition to a significantly increased period of intensive care unit follow-up and duration of postoperative hospitalization (P <.001). CONCLUSION: The present study demonstrated that the perioperative occurrence of conduction disorders after CABG was decreased by antegrade controlled and retrograde continuous combination cardioplegia.
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