Antegrade versus Retrograde Blood Cardioplegia in Left Main Coronary Artery Disease Patients Underwent CABG

Abstract

Background: Cardioplegia is used to protect the heart from ischemic insult. In left main coronary artery disease, free and homogenous  spread and chemical preservation of antegrade cardioplegia is limited. Other option is to bypass the left main stenosis by giving  retrograde cardioplegia.

Objective: This study aimed to compare the postoperative cardiac function, and clinical outcome between  antegrade and retrograde blood cardioplegia in left main coronary artery disease patients who underwent CABG.

Patients and  methods: A randomized retrospective observational comparative study that was done in Beni-Suef University. The study included 40  patients with left main coronary artery disease who had elective isolated on pump CABG between June 2017 to June 2022, of them 20  patients had antegrade cardioplegia and the other 20 had retrograde cardioplegia.

Results: There was no statistical significance  difference between both groups regarding patients’ demographics, baseline clinical data, preoperative investigations, operative and  postoperative data, except in more inotropic support usage (P value 0.024) and more post-operative elevation of cardiac enzymes (P  value 0.028) in antegrade cardioplegia group. Regarding postoperative morbidities there was no statistically significant difference between both groups. Also, there was no complication form retrograde cardioplegia cannula and no mortality in our study group.  

Conclusions: There is no difference between antegrade and retrograde cardioplegia in left main coronary artery disease patient who  underwent CABG except for higher rate of postoperative elevation of cardiac enzymes and more patients required inotropic support with  antegrade cardioplegia, without any difference in the incidence rate of postoperative morbidity and mortality between both groups.