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Cited by 35Cardiac and Coronary Surgery TechniquesTransplantation: Methods and OutcomesBlood transfusion and management

Microplegia during coronary artery bypass grafting was associated with less low cardiac output syndrome: a propensity-matched comparison

Algarni, Khaled D., Weisel, Richard D., Caldarone, Christopher A., Maganti, Manjula, Tsang, Katherine, Yau, Terrence M.·2013·The Annals of Thoracic Surgery
DOI 10.1016/j.athoracsur.2012.09.056
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Abstract

Background Microplegia delivers blood and additives for cardioplegia with minimal crystalloid. We retrospectively compared microplegia with standard 8:1 blood cardioplegia with a propensity-matched analysis in patients undergoing isolated coronary artery bypass graft (CABG) surgery.Methods Prospectively collected data for 2,630 consecutive patients who underwent isolated CABG surgery (2004 to 2006) with the exclusive use of microplegia was compared with an equivalent 3-year cohort (1998 to 2000) of 5,058 consecutive isolated CABG patients with the exclusive use of 8:1 diluted blood cardioplegia. Propensity score matching identified 1,980 matched pairs (in each group) for analysis.Results In the matched groups, the hospital mortality was identical (1.2%). The prevalence of low cardiac output syndrome was significantly (p< 0.001) lower in the later period when microplegia was employed (2.7%) compared with the standard cardioplegia group (5.0%). Although these results may also reflect improvements in care with time, a multivariable logistic regression analysis of the entire cohort (not matched) also demonstrated a twofold independent reduction in low cardiac output syndrome in microplegia patients (odds ratio, 1.9; 95% confidence interval 1.4 to 2.5).Conclusions Compared with 8:1 blood cardioplegia, microplegia during isolated CABG surgery was associated with a lower incidence of postoperative low cardiac output syndrome. Microplegia may reduce postoperative cardiac edema, increase buffering, and permit more rapid recovery of ventricular function. Randomized trials are required to determine whether the relationship between microplegia and reduced low output syndrome is causal or is merely an association.

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Authors
Algarni, K. D., Weisel, R. D., Caldarone, C. A., Maganti, M., Tsang, K., & Yau, T. M.
Affiliations
University of Toronto (CA)
Corresponding author
Yau, Terrence M.
ORCID
Venue
The Annals of Thoracic Surgery
Publisher
Elsevier BV
Published
2013-05
Volume
95
Issue
5
Pages
1532-1538
ISSN
0003-4975 (ISSN-L)
DOI
10.1016/j.athoracsur.2012.09.056
OpenAlex
W2160496834
Cited by
35
References
25
Citations by year
2026: 1 · 2025: 1 · 2022: 2 · 2021: 4 · 2020: 6 · 2019: 3 · 2018: 5 · 2017: 2 · 2016: 2 · 2015: 2 · 2014: 6
FWCI
3.28
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • The Annals of Thoracic Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
  • Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
  • Health Sciences › Medicine › Biochemistry › Blood transfusion and management
Keywords
cardioplegia, coronary artery bypass grafting, low cardiac output syndrome, ventricular function recovery
MeSH terms
Aged, Coronary Artery Bypass, Cardiac Output, Low, Female, Heart Arrest, Induced, Humans, Male, Middle Aged, Postoperative Complications, Prospective Studies, Hospital Mortality, Propensity Score

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