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Category: Cardioplegia

Del Nido vs Hyper

Outcomes of Del Nido and Hyperkalemic Blood Cardioplegia in Adult Cardiac Surgery with Prolonged Aortic Cross-Clamp Times

This study compares the effectiveness of Del Nido cardioplegia (DNC) and hyperkalemic blood cardioplegia (HKB) in adult cardiac surgery with prolonged aortic cross-clamp times. In a retrospective cohort of 388 patients, findings revealed no significant differences in clinical outcomes or myocardial protection, as assessed by troponin profiles. However, DNC required fewer doses, had longer ischemic intervals, and was associated with higher rates of spontaneous rhythm recovery, suggesting logistical and procedural benefits.

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December 21, 2024
del Nido 2024

Early Postoperative Outcomes of Modified Del Nido Cardioplegia in Coronary Artery Bypass Surgery in Patients with Low Ejection Fraction

This study compares the effectiveness of modified del Nido cardioplegia (DNC) with classic blood cardioplegia (BC) in coronary artery bypass grafting (CABG) patients with low ejection fraction (≤35%). Results show that DNC offers comparable myocardial protection to BC while reducing postoperative atrial fibrillation and the need for inotropic agents. DNC also showed lower troponin levels postoperatively, indicating better myocardial recovery, though no significant differences in mortality or hospital stay were observed.

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December 13, 2024
Aortic Rupture

Extracorporeal Off-Pump Antegrade Cerebral Perfusion in Reconstructive Surgery for Type A Aortic Dissection with Cerebral Malperfusion

This study evaluates a novel off-pump axillo-axillary shunt technique for antegrade cerebral perfusion (ACP) during total aortic arch replacement (BF-TAR) in patients with Type A aortic dissection (TAAD) complicated by cerebral malperfusion (CM). The method provides continuous bihemispheric perfusion, reducing risks linked to cardiopulmonary bypass. Among 18 patients, outcomes included low mortality (5.6%), no permanent neurological deficits, and improved perfusion times compared to traditional methods.

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November 28, 2024
Pediatic Cardioplegia

Hyperlactataemia Following Crystalloid Cardiopulmonary Bypass Priming in Paediatric Cardiac Surgery: Benign or Malignant?

This retrospective study examined paediatric patients undergoing cardiac surgery with crystalloid priming to evaluate outcomes related to postoperative hyperlactataemia. Among 186 patients, 53% experienced hyperlactataemia, which was associated with longer cardiopulmonary bypass and ICU stays but did not increase ventilation duration. Findings suggest transient hyperlactataemia may not indicate tissue hypoxaemia, but longer inotropic support and ICU stays necessitate careful management post-surgery.

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November 28, 2024
Cardioplegia 2024

Gradual Reperfusion in Cardioplegia-Induced Cardiac Arrest

This study explores the potential benefits of gradual reperfusion in cardiac surgery patients experiencing cardioplegia-induced cardiac arrest, aiming to reduce ischemia-reperfusion injury. Fifty elective cardiac surgery patients were randomized into two groups: a hyperoxemic control group with conventional reoxygenation and a normoxemic study group with gradual reoxygenation. Results showed that gradual reperfusion was safe but did not significantly reduce ischemia-reperfusion injury compared to standard methods, although potassium levels were lower in the normoxemic group.

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November 3, 2024
Del Nido Cardioplegia

Comparison of Routine Del Nido Cardioplegia vs Two Types of Modified Del Nido Cardioplegias for Myocardial Protection in CABG: A Randomized Double-Blind Clinical Trial

This randomized, double-blind trial compared the effectiveness of routine del Nido cardioplegia with two modified versions (Ringer lactate-based and plain Ringer-based) in coronary artery bypass grafting (CABG) surgery. Among 120 adult patients, no significant differences were found in myocardial protection markers (CK-MB, Troponin T, Troponin I, lactate). However, Troponin T and lactate levels showed time-related effects. All cardioplegia solutions provided comparable protection, suggesting the need for further studies.

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September 27, 2024
Cardioplegia 2024

Comparative Analysis of Del Nido Cardioplegia Versus Blood Cardioplegia in Isolated Coronary Artery Bypass Grafting

This study examined the efficacy of del Nido cardioplegia compared to traditional blood cardioplegia in adult coronary artery bypass grafting. Among 119 patients, the del Nido group showed superior myocardial protection, indicated by lower Troponin I levels and fewer defibrillation attempts post-surgery. Additionally, this group experienced shorter surgery durations, including reduced aortic cross-clamping and total operative times. The findings suggest del Nido cardioplegia as a viable option for these procedures, necessitating a standardized protocol.

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July 17, 2024
Del Nido Hardshell

A Hardshell Reservoir Technique for Administering del Nido Cardioplegia

This article presents a technique for administering del Nido cardioplegia using a homemade circuit composed of a pediatric reservoir, roller pump, coil cooler, and specific tubing. The circuit design enables precise mixing of blood and crystalloid solution, enhancing the accuracy and efficiency of cardioplegic administration. This setup allows for direct blood collection from the cardiopulmonary bypass circuit and controlled delivery of the cardioplegia solution.

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June 9, 2024
HTK Thomas

Comparison of HTK-Custodiol and St. Thomas Solution as Cardiac Preservation Solutions on Early and Midterm Outcomes Following Heart Transplantation

This retrospective study evaluated the effectiveness of two cardiac preservation solutions, HTK-Custodiol and St. Thomas, used in adult heart transplantations at the University Hospital of Lausanne. The study compared outcomes such as hospital mortality, midterm survival, inotropic score, primary graft dysfunction, and rejection score between 154 patients from 2009 to 2020. Results indicated that HTK-Custodiol significantly improved postoperative outcomes, including lower inotropic and rejection scores, reduced 30-day mortality, and enhanced midterm survival compared to the St. Thomas solution.

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June 3, 2024
Myocardial Injury

Hybrid Feature Selection in a Machine Learning Predictive Model for Perioperative Myocardial Injury in Noncoronary Cardiac Surgery with Cardiopulmonary Bypass

This study developed a predictive model for perioperative myocardial injury (PMI) using hybrid feature selection (FS) methods in patients undergoing noncoronary cardiac surgery with cardiopulmonary bypass (CPB). Conducted at Fuwai Hospital, China, the retrospective study included 1130 patients, with an overall PMI incidence of 20.3%. Various machine learning models were evaluated, with the Naïve Bayes model achieving the highest AUC. The study highlighted the importance of factors like prolonged CPB, aortic clamp time, and preoperative low platelet count in predicting PMI risk.

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May 12, 2024
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