Myocardial protection in on-pump coronary artery bypass grafting surgery: analysis of the effectiveness of the use of retrograde Celsior<sup>®</sup>

López-Menéndez, José; Hycka, Javier Miguelena; Morales, Carlos; Callejo, Francisco Javier García; Silva, Jacobo

doi:10.1177/1753944718792428

Cited by 5 publications

(10 citation statements)

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“…The eleven studies 6,8‐11,13‐18 included in the analysis had an aggregate of 5684 participants, 2681 of whom were microplegia patients versus 3003 who received other types of cardioplegia. The characteristics of the included studies are summarized in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…The exceptions were Koechlin et al 18 and Onorati 16 where volumes were not reported. In the two trials by Lopez Menendez et al, 13,14 the volume of crystalloids in the microplegia was not given but reported to be “minimal.” In Menasche et al 8 the volume of diluted cardioplegia was 1000 mL compared to 58 ± 14 mL ( P = .0001), whilst in Albacker et al 17 the volume of crystalloids in the diluted cardioplegia was 740 CC (95% CI: 690‐794) compared to 65 CC (95% CI: 62‐67) ( P < .01). Four trials involving 196 patients reported the volume of crystalloids in mL used in the cardioplegia.…”

Section: Resultsmentioning

confidence: 99%

“…A further four studies were excluded as they were investigating paediatric cases; one study was excluded as it had no reported outcomes; one paper was excluded because it was a review; one paper was excluded because it contained duplicate data; and, three studies were excluded because they had no comparator group (Figure 1). Eleven studies were included in our analysis 6,8‐11,13‐18 …”

Section: Methodsmentioning

confidence: 99%

“…We used a 5% level of significance and 95% confidence intervals (CIs); figures were produced using CMA. Funnel plots were used to analyse pub- The eleven studies 6,[8][9][10][11][13][14][15][16][17][18] included in the analysis had an aggregate of 5684 participants, 2681 of whom were microplegia patients versus 3003 who received other types of cardioplegia. The characteristics of the included studies are summarized in Table 1.…”

Section: Data Synthesismentioning

confidence: 99%

“…In the two trials by Lopez Menendez et al, 13,14 the volume of crystalloids in the microplegia was not given but reported to be "minimal. −422.93, −370.62; I 2 = 94.07%; P < .001) ( Figure S1).…”

Section: Volume Of Crystalloidsmentioning

confidence: 99%

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Microplegia in cardiac surgery: Systematic review and meta‐analysis

et al. 2020

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Background Consensus on the optimum choice of cardioplegia remains elusive. One possibility that has been suggested to have beneficial properties is microplegia, a cardioplegia of reduced crystalloid volume. The aim of this meta‐analysis is to comprehensively investigate microplegia against a range of clinical outcomes. Methods To identify potential studies, systematic searches were carried out in four databases (eg, Pubmed, EMBASE). The search strategy included the key concepts of “microplegia” OR “mini‐cardioplegia” OR “miniplegia” AND “cardiac surgery.” This was followed by a meta‐analysis investigating: mortality, crystalloid volume; cardiopulmonary bypass time; cross‐clamp time; intra‐aortic balloon pump use; spontaneous heartbeat recovery; inotropic support; low cardiac output syndrome; myocardial infarction; acute renal failure; atrial fibrillation, reoperation for bleeding; creatine kinase myocardial band (CK‐MB); intensive care unit (ICU) time and hospital stay. Results Eleven studies comprising 5798 participants were analyzed. Microplegia used a lower volume of crystalloids and led to a higher spontaneous return of heartbeat, odds ratio (OR) 4.271 (95% confidence intervals [CIs]: 1.935, 9.423; I2 = 76.57%; P < .001) and a lower requirement for inotropic support, OR: 0.665 (95% CI: 0.47, 0.941; I2 = 3.53%; P = .021). Microplegia was also associated with a lower CK‐MB release, mean difference (MD) −6.448 ng/mL (95% CI: −9.386, −3.511; I2 = 0%; P < .001) and a shorter ICU stay, MD: −0.411 days (95% CI: −0.812, −0.009; I2 = 17.65%; P = .045). All other comparisons were nonsignificant. Conclusions Microplegia has similar effects to other types of cardioplegia and is beneficial with regard to spontaneous return of heartbeat, inotropic support, ICU stay, and CK‐MB release.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Data Synthesismentioning

confidence: 99%

Section: Volume Of Crystalloidsmentioning

confidence: 99%

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Microplegia in cardiac surgery: Systematic review and meta‐analysis

et al. 2020

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Stone heart syndrome after prolonged cardioplegia induced cardiac arrest in open-heart surgery – a pilot study on pigs

Krasniqi¹,

Ipsen²,

Hejbøl³

et al. 2022

Cardiovascular Pathology

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Celsior^® crystalloid cardioplegia versus standard hyperkalemic normothermic blood cardioplegia: Analysis of myocardial protection in elective mitral valve repair

et al. 2021

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Introduction: With the increase and refinement of video assisted mitral valve surgery, cristalloïd cardioplegia started regaining popularity. The aim of our study was to evaluate the effectiveness of Celsior®, a crystalloid cardioplegic solution, on myocardial protection in elective surgical mitral valve repair in comparison to blood based hyperkalemic cardioplegia. Methods: In this observational retrospective study, all consecutive elective isolated surgical mitral valve repair where Celsior® or normothermic hyperkalemic blood cardioplegia were used were included. Primary endpoint was any sign of myocardial protection failure (troponin levels, need for inotropic or mechanical support, rhythm disturbances, mortality). Secondary endpoint was Celsior® safety (allergic reactions, bleeding, organ toxicities). Results: From January 2009 to August 2016, 382 patients underwent elective isolated mitral valve repair in whom normothermic hyperkalemic blood cardioplegia ( n = 181) or Celsior® ( n = 201) were used. There were no statistically significant differences in baseline characteristics including Euroscore 2. Peak troponin (pg/ml) release and 30-days mortality were not statistically different. Need for cardioversion was significantly more frequent in the Celsior® group (47% vs 13%, p < 0.001). There was no statistical difference in post-operative atrial fibrillation, permanent pacemaker implantation, reoperation for bleeding, transfusion, acute kidney injury, haemoglobin at discharge or length of stay. No allergic reaction to Celsior® occurred. Conclusion: Effective myocardial protection was achieved with the Celsior® cardioplegic solution with no unexpected toxicity. Celsior® may be an efficacious and safe cardioprotective strategy in mitral valve repair.

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Myocardial protection in on-pump coronary artery bypass grafting surgery: analysis of the effectiveness of the use of retrograde Celsior^®

Abstract: An isolated single dose of retrograde Celsior® may be an effective and safe myocardial protection strategy in on-pump CABG.

Cited by 5 publications

References 28 publications

Microplegia in cardiac surgery: Systematic review and meta‐analysis

Microplegia in cardiac surgery: Systematic review and meta‐analysis

Stone heart syndrome after prolonged cardioplegia induced cardiac arrest in open-heart surgery – a pilot study on pigs

Celsior^® crystalloid cardioplegia versus standard hyperkalemic normothermic blood cardioplegia: Analysis of myocardial protection in elective mitral valve repair

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Myocardial protection in on-pump coronary artery bypass grafting surgery: analysis of the effectiveness of the use of retrograde Celsior®

Abstract: An isolated single dose of retrograde Celsior® may be an effective and safe myocardial protection strategy in on-pump CABG.

Cited by 5 publications

References 28 publications

Microplegia in cardiac surgery: Systematic review and meta‐analysis

Microplegia in cardiac surgery: Systematic review and meta‐analysis

Stone heart syndrome after prolonged cardioplegia induced cardiac arrest in open-heart surgery – a pilot study on pigs

Celsior® crystalloid cardioplegia versus standard hyperkalemic normothermic blood cardioplegia: Analysis of myocardial protection in elective mitral valve repair

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Product

Resources

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Myocardial protection in on-pump coronary artery bypass grafting surgery: analysis of the effectiveness of the use of retrograde Celsior^®

Celsior^® crystalloid cardioplegia versus standard hyperkalemic normothermic blood cardioplegia: Analysis of myocardial protection in elective mitral valve repair