Comparison between the Effects of Bretschneider’s HTK Solution and Cold Blood Cardioplegia on Systemic Endothelial Functions in Patients who Undergo Coronary Artery Bypass Surgery: a Prospective Randomized and Controlled Trial

Abstract

Coronary fistulas are rare anomalies that can affect approximately 1% of the population, presenting few specific symptoms, and are often found occasionally in coronary angiography. Here we describe the case of a 61-year-old patient with complaints of precordialgia and dyspnea since adolescence, with late diagnosis of coronary fistulas with drainage to the pulmonary artery, and with unsuccessful percutaneous treatment. Therefore, she underwent open surgery for the correction of the already known fistulas, in addition to the hemangioma involving such vessels, which made the understanding and resolution of this case more complex.

Histidine–tryptophan–ketoglutarate solution versus multidose cardioplegia for myocardial protection in cardiac surgeries: a systematic review and meta-analysis

“…This article updates the previous meta-analysis Reynolds et al 2020 (26), with four added RCTs [ 16 , 17 , 23 , 25 ]. Our findings were consistent with the previous ones to a large extent.…”

“…Another 31 articles were excluded by full-text screening. Finally, 12 trials [ 6 , 10 , 16 – 25 ] were included in our qualitative and quantitative synthesis (Fig. 1 ).…”

“…Potassium (2 mEq/mL) was added at an initial rate of 150 mL/h, followed by 120, 90, 60 mL/h at subsequent doses, and maintenance rate of 40 mL/h. The doses were delivered every 15 min Mercan et al [ 25 ] Turkey 50 patients (25 in each group) The study included patients undergoing elective CABG, who were aged 40–80 years. Having valvulopathy, LVEF < 30%, chronic renal failure, impaired Liver function test result, emergency or redo surgery, history of cerebrovascular or carotid artery disease, history of cardiopulmonary resuscitation were exclusion criteria 20 ml/kg of the solution were administered through an antegrade route.…”

Modified cardiopulmonary bypass with low priming volume for blood conservation in cardiac valve replacement surgery

“…Compared with previous work, the fabricated CPB system in this study included several improvements, but inevitably had limitations. Previous studies have found that adding the CO 2 flush procedure contribute to a reduction of gaseous microemboli in CPB devices and corresponding improved neuropsychological outcomes [14,25,26]. Thus, we implemented the CO 2 flush procedure before surgery in our modified CPB system.…”

Theoretical and Practical Aspects in the Use of Bretschneider Cardioplegia

“…Bretschneider, describing the benefits of every component in his newly devised cardioplegia, mentioned lower concentrations of prime electrolytes (Na + , K + , and Ca 2+ ) compared with other cardioplegias [ 53 ]. By comparison, the hyperkalemic solution interferes in the production of the endothelium-derived relaxing factor, alters myocardial perfusion, and induces smooth muscle proliferation [ 54 , 55 ]. Moreover, in a study conducted by Ilker M. et al, the authors analyzed endothelial injury secondary to Bretschneider infusion versus cold blood cardioplegia in 50 CABG interventions.…”