Original Article

Predictable Spontaneous Beating in 96% of Coronary Bypass Operations

Kaiser Foundation Hospital, Los Angeles, CA

^* Address correspondence to: William I. Brenner MD, 1505 N. Edgemont St., Los Angeles, CA 90027.

Abstract

To determine the incidence of spontaneous beating in isolated coronary bypass operations, one cardiac surgeon's experience with 677 consecutive cases over an 8 1/2 year period (1980-1988) was studied. Myocardial protection included hypothermic (4°C) blood cardioplegia containing procaine and papaverine, topical cooling (4°C) and systemic hypothermia (25°C). During warming, 100 mg of lidocaine was administered when body temperature reached 30°C. Six hundred fifty-one patients (96%) had spontaneous beating after removal of the aortic cross-clamp following completion of distal anastamoses. Electrical cardioversion was required immediately in 26 of these 677 patients (4%) and in an additional 32 (5%) later in the operation, usually when ventricular fibrillation was induced by manipulation of the beating heart to inspect the distal anastamoses. Therefore, 619 of these 677 coronary bypass patients (91 %) were spared intraoperative electrical cardioversion and its potential for myocardial damage.