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Category: Cardioplegia

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
Myocardial Protection

Dexmedetomidine Pretreatment Confers Myocardial Protection and Reduces Mechanical Ventilation Duration for Patients Undergoing Cardiac Valve Replacement under Cardiopulmonary Bypass

This study investigates the effects of dexmedetomidine (Dex) pretreatment in patients undergoing cardiac valve replacement under cardiopulmonary bypass. In the Dex group, the time to the first rescue dose of propofol was longer, and the total propofol dosage was less than in the control group. Additionally, the Dex group showed reduced cardiac injury markers and inflammation, requiring less mechanical ventilation time than the control group. The findings suggest that Dex pretreatment offers myocardial protection and optimizes postoperative outcomes.

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May 2, 2024
Ischemic Heart

Remote Ischemic Preconditioning and Cognitive Dysfunction Following Coronary Artery Bypass Grafting: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

This systematic review and meta-analysis evaluates the effectiveness of remote ischemic preconditioning (RIPC) in preventing cognitive dysfunction after coronary artery bypass grafting (CABG) with cardiopulmonary bypass. Despite hypothesized benefits, the meta-analysis of five studies encompassing 1,843 participants showed that RIPC does not significantly reduce the incidence or severity of postoperative cognitive dysfunction. The findings suggest that RIPC is not effective as a neuroprotective strategy in CABG patients.

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April 27, 2024
Del Nido Cardio

Comparison of Del Nido Cardioplegia and Crystalloid Blood Cardioplegia on Arrhythmia and Early Results

This study compares the efficacy of Del Nido cardioplegia (DN) and traditional crystalloid blood cardioplegia in patients undergoing coronary artery bypass surgery, focusing on their effects on arrhythmias and early surgical outcomes. The research involved 175 patients using crystalloid cardioplegia and 150 patients using DN solution. Findings suggest that DN solution, particularly when part of the dose is administered through grafts, leads to better control of arrhythmias post-surgery, reduced need for pacing, and shorter hospital and intensive care unit stays.

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April 21, 2024
Cardioplegia 123

Myocardial Protection: Histological Effects of Single-Dose Cardioplegic Solutions in the CARDIOPLEGIA Trial

This study aims to compare the myocardial protection offered by single-dose cardioplegic solutions (Custodiol, del Nido, and modified del Nido) using histological analysis in a double-blind clinical trial. At least 90 patients undergoing cardiac surgery will be randomly assigned to one of the three solutions, with myocardial biopsies collected before and after cardiopulmonary bypass. The research seeks to determine the most effective solution for minimizing ischemic damage during cardiac surgery, which is critical for patient safety and outcome optimization. Results could influence clinical protocols and cardioplegic solution selection globally.

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March 22, 2024
Myocardial Protection

Effect of Perioperative Nicorandil on Myocardial Protection in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass, a Retrospective Study

This retrospective study evaluates the myocardial protective effects of perioperative Nicorandil (NICD) in patients undergoing cardiac surgery with cardiopulmonary bypass. Analyzing data from 2406 patients, the study found that NICD significantly reduced the incidence of myocardial injury and postoperative acute liver injury (ALI), and shortened the duration of mechanical ventilation, ICU and hospital length of stay, and chest drainage. These findings suggest that NICD can offer substantial myocardial protection and improve postoperative outcomes in cardiac surgery patients.

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February 8, 2024
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