Background: Patients who undergo coronary artery bypass graft (CABG) surgery,
particularly those with significant left main coronary artery disease (LMCAD),
require optimal myocardial protection. The selection between Custodiol and warm
blood cardioplegia remains critical in enhancing surgical outcomes and improving
postoperative quality of life. This study sought to compare Custodiol and warm
blood cardioplegia regarding myocardial protection during CABG surgery.
Methods: This randomized controlled clinical trial was carried out on 100 patients
with significant LMCAD. Patients underwent CABG surgery using either Custodiol
(Group I, n= 50) or intermittent antegrade warm blood cardioplegia (Group II, n=
50). In Group I, 13 patients were female (26%); in Group II, 15 were female (30%).
Results: Both groups had comparable preoperative demographics. Use of
hemofilter [8 (16%) vs. 1 (2%), p= 0.004], DC shock [ 6 (12%) vs. 1 (2%), p= 0.037]
were more common in Group I. Arrhythmia occurred more frequently in Group I
intraoperatively [ 9 (18%) vs. 2 (4%), p= 0.009]. No early mortality was observed in
either group. Postoperative data revealed no significant differences between the
groups in vital parameters, complications, echocardiographic data, or mortality.
Conclusion: Both Custodiol and warm blood cardioplegia demonstrated
comparable efficacy and safety profiles for myocardial preservation during CABG
surgery in patients with significant LMCAD. Custodiol could be an effective
alternative to blood cardioplegia in patients with LMCAD.