Ranolazine and Cardioprotection During Myocardial Ischemia

Cardioprotective Effects of Ranolazine in Myocardial Infarction Mediated by Stimulation of the Endogenous Mediators Involved in Ischemic Preconditioning

March 26, 2026 No Comments

This experimental rat-heart study tested whether ranolazine protects the myocardium through pathways similar to ischemic preconditioning. Using a Langendorff ischemia-reperfusion model, ranolazine reduced infarct size, LDH, CK-MB, troponin I, and improved ventricular function. These benefits were lost when nitric oxide, adenosine, bradykinin, or ATP-sensitive potassium channel pathways were blocked, supporting their role in ranolazine-mediated cardioprotection.

Minimally Invasive Aortic Valve Replacement and Cardioplegia Strategy Comparison

Cardioplegia Strategies in Minimally Invasive Aortic Valve Replacement: An Inverse Probability of Treatment Weighting Analysis

March 25, 2026 No Comments

This retrospective single-center study compared four cardioplegia strategies in 543 patients undergoing minimally invasive aortic valve replacement from 2010 to 2025. After inverse probability weighting balanced baseline differences, Calafiore and Custodiol were associated with less postoperative atrial fibrillation, lower CK/CK-MB release, and fewer respiratory complications than Buckberg, while mortality, stroke, ICU stay, hospital stay, and postoperative LVEF were similar.

Custodiol Versus Del Nido Cardioplegia in Minimally Invasive Mitral Valve Repair–a Propensity Score-Matched Study

March 24, 2026 No Comments

This propensity score-matched, single-center study compared Custodiol and Del Nido cardioplegia in 778 patients undergoing minimally invasive mitral valve repair. Del Nido was linked to lower postoperative CK and CK-MB release, less need for cardioversion after declamping, fewer shocks, higher perioperative sodium, and lower early inotrope use. Major complications, length of stay, and 30-day mortality were similar, suggesting better myocardial protection with Del Nido.

Comparing Myocardial Protection Strategies in Heart Transplantation

Long-Term Outcome of Myocardial Protection in Heart Transplantation: Comparison Among 3 Different Solutions

February 23, 2026 No Comments

This 20-year single-center study of 528 heart transplant recipients compared three preservation solutions: Celsior, HTK-Custodiol, and St Thomas. HTK-Custodiol was associated with a significantly higher rate of severe primary graft dysfunction (10.2% vs 4.5%), but long-term survival and rejection rates were similar across groups. Severe PGD, ischemic time, and donor/recipient age predicted late mortality. Authors advise caution with HTK-Custodiol.

Precision and Protection: Advanced Myocardial Preservation in Complex Cardiac Surgery

Custodial-HTK Cardioplegia in Conventional Cardiac Surgery: A Retrospective Analysis From UiTM

February 4, 2026 No Comments

This retrospective cohort study from a Malaysian tertiary cardiac center compares Custodial-HTK cardioplegia with conventional blood cardioplegia in elective on-pump cardiac surgery. Although Custodial-HTK was preferentially used in higher-risk and more complex cases with lower baseline LVEF and longer bypass times, postoperative outcomes, ICU stay, hospital stay, and 30-day mortality were comparable, supporting its safety and effectiveness.

Global Teamwork in Modern Myocardial Protection: Alternative Base Solutions for del Nido Cardioplegia

Alternative Base Solutions for del Nido Cardioplegia: Composition, Rationale, and Clinical Evidence

January 31, 2026 No Comments

This comprehensive review examines alternative crystalloid and whole-blood base solutions for del Nido cardioplegia, including normal saline, lactated Ringer’s, plain Ringer’s, Isolyte S, Ionosteril, and whole blood. Drawing on experimental models, randomized trials, and clinical studies, the article demonstrates that these alternatives provide myocardial protection and postoperative outcomes comparable to Plasma-Lyte A when appropriately buffered, supporting cost-effective and globally accessible cardiac surgery practice.

Active Myocardial Protection During Cardioplegic Arrest

Molecular and Cellular Mechanisms of Cardioplegic Protection in Surgical Myocardial Revascularization

January 31, 2026 No Comments

This comprehensive review explores how cardioplegia actively protects the myocardium during coronary artery bypass grafting. Beyond inducing cardiac arrest, cardioplegic solutions modulate calcium homeostasis, mitochondrial function, oxidative stress, inflammation, and apoptosis. By suppressing electromechanical activity and metabolic demand, cardioplegia prolongs ischemic tolerance and mitigates reperfusion injury, offering critical insights for optimizing myocardial protection strategies in modern cardiac surgery.

Perioperative Bleeding Is Not an Independent Risk Factor for Acute Kidney Injury

Comparable Renal Effects of Histidine-Tryptophan-Ketoglutarate and DelNido Cardioplegia in a Porcine Model of Cardiac Arrest

November 20, 2025 No Comments

This study evaluated the renal impact of two cardioplegic solutions—HTK and DelNido—in pigs undergoing cardiac arrest. Despite DelNido showing better electrolyte and hemoglobin stability, both solutions induced comparable levels of renal injury. Biomarkers (NGAL, FABP-1, cystatin C), histological damage, oxidative/nitrosative stress, and apoptosis indicators revealed no significant differences, supporting similar renal safety profiles during 90-minute cardiac arrest.

The Novel St Thomas’ Hospital Polarizing Blood Cardioplegia: Results in Hearts With Reduced Ejection Fraction

July 13, 2025 No Comments

This study investigates the efficacy of a new St Thomas’ Hospital polarizing cardioplegia (STH-pol) versus standard depolarizing cardioplegia (STH-control) in rats with chronic myocardial infarction. Although STH-pol showed trends toward better coronary flow and reduced myocardial oxygen consumption, no statistically significant difference in myocardial protection was found. Both solutions demonstrated comparable recovery and energy preservation.

Patient Outcomes After Introduction of Novel Myocardial Protection Protocol for Prolonged Aortic Cross-Clamping

June 24, 2025 No Comments

This study evaluates the impact of a revised myocardial protection protocol implemented in 2021 at St. Marianna University School of Medicine for patients undergoing cardiac surgery with prolonged aortic cross-clamping (>4 hours). The revised protocol, focusing on the timing and method of blood cardioplegia administration, led to significantly lower postoperative creatine kinase levels and shorter hospital stays, indicating improved myocardial protection without altering the cardioplegia solution itself.