WARM AND AEROBIC HEART-SURGERY - RESULTS IN 530 PATIENTS

Between February and October 1991, 530 consecutive patients underwent myocardial revascularization or valvular surgery with warm continuous antegrade and retrograde cardioplegia (37-degrees-C). Three hundred and thirty three patients had isolated myocardial revascularization, 159 valvular surgery alone and 25 had combined valvular and coronary bypass. The global mortality was 5.1 %, 3.7 % for coronary bypass, 7.5 % for valvular surgery and 8 % for combined valvular and coronary surgery. A multivariate analysis identified the "reperfusion time" as the only predictive factor of hospital mortality (p < 0.001). Intraortic balloon counterpulsation was required postoperatively in 3,2 % of cases, 5.2 % of coronary bypass and 0.8 % of the valvular patients. Inotropic drugs were used to come off cardiopulmonary bypass in 16.5 % of coronary and 37.5 % of valvular patients. There were 0.9 % perioperative infarctions : 1.2 % in the coronary bypass cases and 0.6 % in the valvular cases. Spontaneous return to sinus rythm was observed in 87.9 % of cases. The average 'reperfusion time" was 20.48 +/- 0.7 mn. Analysis of the influence of aortic cross clamp time on cardiac morbidity in two groups of coronary patients (Group I : short cross clamp time less than 60 mn ; Group II : long cross clamp time, 60 to 33 mn) showed that the hospital mortality, the prevalence of the use of inotropic drugs and balloon counterpulsation the postoperative cardiac index, the rate of spontaneous de fibrillation and the reperfusion time did not depend on the aortic cross clamp time. Cardiac morbidity