Warm reperfusion and myocardial protection

Background. The aim of this study was to determine whether warm reperfusion improves myocardial protection with cardiac troponin I as the criteria for evaluating the adequacy of myocardial protection. Methods. One hundred five patients undergoing first time elective coronary bypass surgery were randomized to one of three cardioplegic strategies of either (1) cold crystalloid cardioplegia followed by warm reperfusion, (2) cold blood cardioplegia followed by warm reperfusion, or (3) cold blood cardioplegia with no reperfusion. Results. The total amount of cardiac troponin I released tended to be higher in the cold blood cardioplegia with no reperfusion group (3.9 +/- 5.7 mu g) than in the cold blood cardioplegia followed by warm reperfusion group (2.8 +/- 2.7 mu g) or the cold crystalloid cardioplegia followed by warm reperfusion group (2.8 +/- 2.2 mu g), but not significantly so. Cardiac troponin I concentration did not differ for any sample in any of the three groups. Conclusions. Our study showed that the addition of warm reperfusion to cold blood cardioplegia offers no advantage in a low-risk patient group. (C) 1998 by The Society of Thoracic Surgeons.