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IPA

Category: Cardioplegia

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
Del Nido

Del Nido vs. Cold Blood Cardioplegia for High-Risk Isolated Coronary Artery Bypass Grafting in Patients with Reduced Ventricular Function

This study compares the effectiveness of del Nido and cold blood cardioplegia in high-risk patients with reduced ejection fraction undergoing isolated coronary artery bypass grafting. With 45 patient pairs matched for several factors, the research found that del Nido cardioplegia resulted in a higher rate of spontaneous return to sinus rhythm post-surgery and showed a trend towards lower creatine kinase release and atrial fibrillation rates, though mortality and major adverse cardiac events were similar between the two groups. The findings suggest del Nido cardioplegia may offer satisfactory myocardial protection in this patient demographic, highlighting the need for further prospective trials.

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February 7, 2024
Myocardial Protection

Comparison of Cardioplegic Solutions in Coronary Bypass Surgery Over Autophagy and Apoptosis Mechanisms

This study aimed to examine myocardial damage at the molecular level in coronary bypass surgery patients, focusing on autophagy and apoptosis mechanisms. It found no significant difference in myocardial protection between Custodiol cardioplegia (CC) and Blood cardioplegia (BC) solutions, despite variations in BECLIN and CASPASE gene expressions in myocardial tissues.

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January 28, 2024
Myocardial Ultrasound

Ultrasound Study of Right Ventricular Myocardial Perfusion and Functional Changes in Hypertrophic Cardiomyopathy

This study aimed to develop a dynamic predictive model for cardiac surgery-associated acute kidney injury (CSA-AKI), using data from 910 cardiac surgery patients to combine preoperative risks and cardiopulmonary bypass (CPB) related factors into a multifactorial dynamic perfusion index (MDPI). The study found that the MDPI, which includes dynamic CPB quality indices, has better predictive ability for CSA-AKI than existing static models, suggesting its potential as a more effective tool for integrating various risk factors in patient care.

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January 27, 2024
Blood CPG

Randomized Controlled Trial of Remote Ischemic Preconditioning in Children Having Cardiac Surgery

In a study on children undergoing cardiac surgery, remote ischemic preconditioning showed a potential for reducing kidney injury, but there were no significant differences in cardiac markers or secondary clinical outcomes. Although there was a minor trend towards kidney protection, larger studies are needed to confirm the efficacy of this intervention in a high-risk pediatric population.

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January 6, 2024
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