COMPARISON OF ANTEGRADE WITH ANTEGRADE/RETROGRADE CARDIOPLEGIA FOR MYOCARDIAL REVASCULARIZATION IN CORONARY ARTERY BYPASS GRAFTING

Abstract

Background: Cardioplegia aimed to protect myocardial function during cardiac surgery and facilitate surgical
procedures providing a quiet and bloodless operative field. Integrated cardioplegia offers superior myocardial
protection of left ventricular free wall and septum compared with antegrade mode of cardioplegia delivery.
Objective: To compare the post-operative myocardial protection indicators of antegrade cardioplegia and
antegrade/retrograde cardioplegia during surgery in patients undergoing coronary artery bypass grafting surgery.
Study Design: Prospective Cohort Study
Setting: Department of Cardiac Surgery, National Institute of Cardiovascular Diseases, Karachi.
Duration: 3rd August 2019 To 2nd February 2020
Material and Methods: 80 patients underwent CABG with antegrade/retrograde cardioplegia (exposed Group) and
80 patients with antegrade cardioplegia (unexposed Group) were included. Post inotropic Support and retained
postoperative ejection fraction were obtained. Comparison between exposed and unexposed group was done
applying chi-square test or fisher exact test. P-value ≤0.05 was considered as significant.
Results: The mean postoperative ejection fraction was 50.43±9.25% in exposed group while in unexposed group it
was 45.06±7.35% respectively. Total 52.5% patients were retained postoperative ejection fraction in exposed group
and 26.3% patients in unexposed group while inotropic support were required for 72% patients in exposed and 25%
in unexposed group. Significant association of study group with retained postoperative ejection fraction and
inotropic support.
Conclusion: The retained postoperative ejection fraction in exposed group was more as compared to unexposed
group. The inotropic support was required less in unexposed groups as compared to exposed group.