Using Bretshnader Solution for Pharmaco-Cold Cardioplegic Protection of Myocardium during Coronary Artery Bypass Grafting

Postoperative hemodynamic disturbances during surgery with cardiopulmonary bypass can account for 70% of cases. This statistics is largely due to the inconsistency of myocardial protection with the level of hypoxia during the main phase of the operation. The purpose of the study was to check the effectiveness of cardioprotection using Bretschneider cardioplegic solution during coronary artery bypass grafting. Material and methods. The study included 60 patients who underwent the coronary artery bypass grafting in combination with aneurysmoplasty of left ventricular. The average age was 68.96±1.81 years old. The average body weight was 86.5±1.44 kg. The coronary artery bypass grafting was performed under moderate hypothermia (the central temperature was + 30°C - +32°C). The productivity of the cardiopulmonary bypass machine during the period of perfusion was 2.4 liters / min. / m2. To assess the effectiveness of myocardial protection, we analyzed the doses of inotropic agents and the growth dynamics of the cardiospecific enzymes: MB-CPK and TnI. Results and discussion. Dopamin was used in medium doses in 49 patients (81.7%) and in small ones in 11 patients (18.3%). Adrenaline was used in small doses in 4 (6.7%) patients. In the postperfusion period, rhythm disturbances were observed in 6 supervised patients (10% of cases). The value of Troponin I was 1.68 ± 0.04 ng/ml, while MB-CPK was 6.8±0.07 MO/l and corresponded to an uncomplicated course of the postoperative period. Conclusions. Pharmaco-cold Bretschneider cardioplegic solution ensured a reliable level of cardioprotection, which was confirmed by the absence of pathological growth of cardiovascular enzymes, low need for inotropic agents and low frequency of arrhythmias.