Either on pump beating or cold blood cardioplegic arrest
technique was used for myocardial protection in these patients.
Surgery was performed through a median sternotomy with cardiopulmonary bypass and cold cardioplegic arrest
. The pericardium was opened, and a large mass was evident arising from the free wall of LV.
Moreover, cardioplegic arrest
abolishes the squeezing effect of heart contraction on coronary microvasculature and further compromises coronary blood perfusion.
(1) Although cardioplegic arrest
is induced during cardiac surgery, the incidence of complications such as peri-operative myocardial infarction remains high (9.8%).
Hence, surgery was performed on Cardiopulmonary Bypass (CPB) with moderate hypothermia and cold-blood cardioplegic arrest
after cross clamping the aorta and looping and snugging the pulmonary artery.
Ischaemic reperfusion injury (IRI) following cardioplegic arrest
results in increased ROS production.
Under these circumstances, the current clinical practice offers the ability of performing CABG with CPB with an empty beating heart (ONCAB/BH), which is advantageous over ONCAB as it benefits from the hemodynamic stability afforded by CPB, without being implicated by cardioplegic arrest
and possible myocardial ischemic damage .
Apart from the four patients who underwent the extracardiac conduit procedure, aortic clamp was placed in all the remaining patients after CPB was established, and cardioplegic arrest
was achieved by the administration of a single dose of crystalloid cardioplegia.
The method used for short-term preservation consists of initial cardioplegic arrest
of the donor heart with a hyperkalaemic and hypertonic solution, together with topical cooling of the myocardium.
In humans with normal left ventricular (LV) function, the use of L-arginine cardioplegic arrest
during coronary artery graft surgery has been shown to significantly decrease the biochemical markers of oxidative stress (4,5) inflammation (6) and myocardial cell death (4,7).
Petersen et al., "Histidine and other amino acids in blood and urine after administration of Bretschneider solution (HTK) for cardioplegic arrest
in patients: effects on N-metabolism," Amino Acids, vol.
Coronary-artery bypass graft (CABG) surgery reduces mortality in patients with severe coronary artery disease.1 During the last 30 years, coronary artery bypass grafting (CABG) was performed primarily with the use of cardiopulmonary bypass system ("on pump") using cardioplegic arrest
. Historically, on-pump CABG has shown improvements in ischemic symptoms and prolonged survival in selected patients.2,3 Using this approach, peri-operative mortality is about 2%, and 5-7% are additional complications along with mortality like myocardial infarction, stroke, and renal failure.4