COMPARISON OF RETROGRADE VERSUS ANTROGRADE-RETROGRADE COLD BLOOD CARDIOPLEGIA: A RANDOMIZED CLINICAL TRIAL IN PATIENTS WITH CORONARY ARTERY BYPASS GRAFTING

Abstract   INTRODUCTION: The quality of myocardial protection during Coronary Artery Bypass Grafting (CABG) has a direct effect on post-operative cardiac function, recovery and complications. This study aimed to reveal the benefits of retrograde cardioplegia alone or with antrograde in CABG for myocardial function.   METHODS: A total number of ۹۰ patients that underwent CABG between ۲۰۰۵ and ۲۰۰۶ were assigned randomly into two groups according to myocardial protection technique; Antrograde cold blood cardioplegia (ACBC) and retrograde cold blood cardioplegia (RCBC). The results were assessed considering clinical outcome, assessment of early systolic function by means of cardiac output (CO), stroke, left ventricular and atrial fibrillation and transient atrioventricular block after coming off bypass.   RESULTS: The mean of age, gender, diabetes, hypertension, euro score, anatomical pattern of coronary disease, indexed left ventricular mass and ejection fraction (EF) were similar in the two groups. Complete LAD occlusion (۹۵% in cross-sectional area of proximal LAD) of grafts was ۹۵.۵۵% in the RCBC group and ۹۷.۷۷% in the A/RCBC group. There were no patients suffering from severe impairment of left ventricle function and EF less than ۳۵%. The cross-clamp time was same in both groups.    CONCLUSION: The main findings of this study showed no significant difference between RCBC and A/RCBC procedure on myocardial function and EF also in patient with normal condition. Keywords: Retrograde, Antrograde, Cardioplegia.