Comparison of Clinical Outcomes of Two Different Cardioplegic Solutions in Patients Undergoing Coronary Artery Bypass Graft Surgery; A randomize clinical trial

Abstract

Background: Usually, manual cardioplegic solutions with low magnesium and lidocaine, and corporate solutions with high magnesium and procaine, are the only common solutions used to induce cardiac arrest during coronary artery bypass graft (CABG) surgery. This study compares the clinical outcomes of these two solutions. Materials and Methods: This randomized, single-blind clinical trial was conducted on 70 patients undergoing CABG at Chamran Hospital in Isfahan. In the first group, a manual cardioplegic solution was used. In the second group, a corporate cardioplegic solution (Blood; Shahid Ghazi Company) was used. Subsequently, inflammatory factors, complications, and outcomes were evaluated in the two groups. Results: There were no significant differences between the two groups in the incidence of arrhythmia after declamping, the total inotropic support required within 24 h post-surgery, changes in electrolytes, or markers of myocardial injury (P > 0.05). However, the time to return to heart rhythm in the manual cardioplegic solution group, with a mean of 146.06 +/- 118.39 s, was significantly longer than that in the corporate cardioplegic solution group, with a mean of 90.60 +/- 59.72 s (P = 0.016). Conclusion: This study found no difference in patient outcomes between the corporate cardioplegic solution (high magnesium/procaine) and the manual solution (lower magnesium/lidocaine). Therefore, the manual solution can be used in some cases, as its lower magnesium level avoids hypermagnesemia and does not cause cardiac muscle weakness during mechanical activities.