Cold cardioplegia versus hypothermia for myocardial protection

Conti, Vincent R.; Bertranou, Enrique G.; Blackstone, Eugene H.; Kirklin, John W.; Digerness, Stanley B.

doi:10.1016/s0022-5223(19)41005-2

Cited by 194 publications

(9 citation statements)

References 13 publications

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“…The PMI rate increases with duration of cardio-pulmonary bypass [10,21,42,74]. The myocardial preservation technique used during aortic cross clamping is of great importance [1,10,24,25,56,92]. The technique with cold potassium cardioplegia currently used is claimed to be among those factors that have contributed most to the reduction in the frequency of PMI during CABG [56,59].…”

Section: Variables Associated With An Increased Risk Of Pmimentioning

confidence: 99%

Perioperative Myocardial Infarction

Haagensen¹,

Steen²

1988

British Journal of Anaesthesia

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The risk of developing myocardial infarction (MI) in connection with surgery and anaesthesia has been recognized for at least 75 years [19, 79, 93, 101]. Since then numerous reports have been published, some describing the incidence and characteristics of perioperative myocardial infarction (PMI), others the risk factors involved. To compare these publications is difficult because of the great span in years between various studies, and the variability in study conditions such as selection and size of population, the use of a retrospective or a prospective approach, variations in postoperative care, the method of diagnosis of PMI etc. These factors can at least partly explain the variability and even contradictions observed in results. In most of these studies statistical evaluation also leaves much to be desired. The questions are often multifactorial, without the appropriate tests being performed. Performing simple chi-squared tests on whether sex, age, type or duration of anaesthesia etc, influence the infarction rate, does not provide a correct picture. There is often some co-variation between many of these factors, such as duration of anaesthesia and type of surgery. Thus the papers should be evaluated critically and the effects of a single factor reported in a single paper should be interpreted with caution. Even more impressive, therefore, are the similarities in some of the results in spite of these differences in methodology, and certain trends appear in the literature that are important to the daily work of the anaesthetist. In this review we have concentrated on the epidemiological aspects of PMI and the risk factors that have practical consequences in the treatment of patients. Frontline research concerning the pathophysiology of myocardial ischaemia and infarction and possible effects of

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Section: Variables Associated With An Increased Risk Of Pmimentioning

confidence: 99%

Perioperative Myocardial Infarction

Haagensen¹,

Steen²

1988

British Journal of Anaesthesia

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“…Myocardial damage during cardiac surgery is the most important cause of mortality and morbidity. Cardioplegia has been used for many years in cardiac surgery for myocardial protection due to systemic and local hypothermia [1,2]. Cardioplegia solution, which is the technique of providing elective and chemically cardiac arrest, was first applied in 1955 by Melrose with potassium [3].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the cardioprotective effects of crystalloid del Nido cardioplegia solution via a rapid and accurate cardiac marker: heart-type fatty acid-binding protein

Kirişçi¹,

Koçarslan²,

Aykan³

et al. 2020

Turk J Med Sci

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Background/aim: Our aim in this study was to compare the efficacy and safety of crystalloid del Nido solution and cold blood cardioplegia solution on clinical and laboratory parameters. Materials and methods: Sixty patients who underwent elective coronary bypass operation between July 2019 and January 2020 were included in our study. Patients were divided into 2 groups of 30 patients using del Nido solution (DNS) and cold blood cardioplegia solution (CBCS), which were given for cardiac arrest. Demographic data, preoperative, postoperative 0th h, 6th h and 4th day creatine kinase myocardial band (CK-MB) and troponin I values were compared with a specific cardiac enzyme heart-type fatty acid-binding protein (H-FABP). Results: We found that aortic cross clamp duration and cardiopulmonary bypass (CPB) time were shorter in patients using del Nido solution than cold blood cardioplegia solution (57.30 ± 23.57 min, 76.07 ± 27.18 min, P = 0.006) (95.07 ± 23.06 min, 114.13 ± 33.93, P = 0.014). Total cardioplegia solution volume was higher in the cold blood cardioplegia solution group (1426.67 ± 416.00 vs. 1200 ± 310.73 P = 0.02). Preoperative and postoperative levels of cardiac enzymes including CK-MB, troponin I and H-FABP were comparable in del Nido solution and cold blood cardioplegia solution groups. Conclusion: According to these results, when we compare both demographic data and CK-MB, troponin I and H-FABP levels, both cardioplegia solutions were comparable regarding safety and efficacy in terms of myocardial protection.

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“…Ensuring adequate myocardial protection during the surgery, as well as before and after the operation, is the most significant factor of success [ 1 , 2 ] . Cardioplegia, as well as local and systemic hypothermia, have been used in cardiac surgery for many years for myocardial protection [ 3 , 4 ] . The causes of myocardial damage are global myocardial ischemia (aortic cross-clamp) and especially reperfusion [ 5 ] .…”

Section: Introductionmentioning

confidence: 99%

Comparison of the operative and postoperative effects of del Nido and blood cardioplegia solutions in cardiopulmonary bypass surgery

Orak

Koçarslan

Boran

et al. 2020

Braz J Cardiovasc Surg

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Objective Our goal was to compare the operative and postoperative effects of del Nido cardioplegia (DN group) and blood cardioplegia (BC group) performed in cardiac surgery. Methods A total of 83 patients were included, separated into DN group and BC group. The operative and postoperative effects of the two groups were compared for the first 24 hours until extubation. The operative and postoperative complete blood count (CBC), biochemical values and clinical parameters were compared. Results The first control activated clotting time (ACT) levels in DN group patients were lower ( P =0.003) during the operation. The amount of cardioplegia in DN group were lower than that in BC group ( P =0.001). The pump outflow and postoperative lactate level of DN group were lower than those of BC group ( P =0.005, P =0.018, respectively), as well as the amounts of NaHCO3 ( P =0.006) and KCl ( P =0.001) used during the operation. The same occurred with the first monocytes (Mo) and mean corpuscular volume (MCV) levels in the postoperative intensive care unit ( P =0.006, P =0.002). However, the first glucose level and the eosinophil (Eo) level were higher in DN group ( P =0.011, P =0.047, respectively). Conclusion In the operative evaluation, the amount of cardioplegia, the first ACT levels, the pump outflow lactate level and the amounts of NaHCO 3 and KCl in DN group were lower. In postoperative evaluation, measured level of lactate, Mo and MCV in DN group were all lower; their glucose and Eo levels were higher.

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Cold cardioplegia versus hypothermia for myocardial protection

Cited by 194 publications

References 13 publications

Perioperative Myocardial Infarction

Perioperative Myocardial Infarction

Evaluation of the cardioprotective effects of crystalloid del Nido cardioplegia solution via a rapid and accurate cardiac marker: heart-type fatty acid-binding protein

Comparison of the operative and postoperative effects of del Nido and blood cardioplegia solutions in cardiopulmonary bypass surgery

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