A Hardshell Reservoir Technique for Administering del Nido Cardioplegia

June 9, 2024 No Comments

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.

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

June 3, 2024 No Comments

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.

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

May 12, 2024 No Comments

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.

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

May 2, 2024 No Comments

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.

Investigation of the Association between Bilateral Selective Anterograde Cerebral Perfusion and Postoperative Ischemic Stroke in Obese Patients with Emergency Surgery for Acute Type A Aortic Dissection

April 29, 2024 No Comments

Background and objectives: The relationship between cerebral perfusion and new postoperative ischemic stroke in obese patients is not well defined. The aim of this study

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

April 27, 2024 No Comments

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.

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

April 21, 2024 No Comments

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.

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

March 22, 2024 No Comments

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.

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

February 8, 2024 No Comments

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.

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

February 7, 2024 No Comments

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.