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.

Del Nido Cardioplegia in Adult Cardiac Surgery: A Narrative Review

May 13, 2025 No Comments

This review explores the use of Del Nido cardioplegia in adult cardiac surgery, originally developed for pediatric use. It outlines its composition, benefits over traditional blood cardioplegia, and its mechanism in protecting the myocardium from ischemia-reperfusion injury. The article compiles data showing its efficacy in reducing cross-clamp times, myocardial injury, and transfusion requirements, with comparable or improved clinical outcomes.

Comparison of Del Nido and Histidine-Tryptophan-Ketoglutarate Cardioplegia Solutions: An Animal Study With Prolonged Ischaemia

April 3, 2025 No Comments

This study compares Del Nido (DN) and Bretschneider histidine-tryptophan-ketoglutarate (HTK) cardioplegia solutions in a porcine model of prolonged ischaemia. DN demonstrated superior left ventricular function, spontaneous return to sinus rhythm, and less haemodilution and endothelial dysfunction compared to HTK. Histological and biochemical markers of injury, stress, and apoptosis showed no significant differences, suggesting DN offers enhanced myocardial protection during cardiac surgery.

Cerebral Inflammation in an Animal Ischemia–Reperfusion Model Comparing Histidine-Tryptophan–Ketoglutarate and Del Nido Cardioplegia

March 30, 2025 No Comments

This study compares two cardioplegic solutions—HTK and Del Nido—for their impact on cerebral inflammation in a porcine cardiopulmonary bypass model. Results showed that while both solutions produced comparable hypoxia and inflammation markers overall, HTK led to more pronounced hyponatremia, hypochloremia, and increased IL-1β mRNA in certain brain regions. Del Nido cardioplegia provided more stable electrolyte levels and less cerebral inflammation.

Buckberg vs. Del Nido in Isolated Aortic Valve Replacement: A Prospective, Two-Center, Randomized Trial

March 16, 2025 No Comments

This study compares Buckberg (BS) and Del Nido (DNS) cardioplegia in isolated aortic valve replacement (AVR) through a two-center randomized trial with 311 patients. While postoperative creatine kinase and troponin levels showed no significant differences, the DNS group had better intraoperative glycemic control, higher spontaneous rhythm rates, and fewer cases of ventricular fibrillation requiring defibrillation. The study supports DNS as a viable alternative with workflow advantages.

Gradual Oxygen Exposure During Coronary Bypass for Acute Myocardial Infarction: A Retrospective Cohort Study

March 15, 2025 No Comments

This study examines the impact of gradual oxygen exposure during emergency coronary bypass surgery for acute myocardial infarction (MI). A retrospective cohort of 66 patients was analyzed, comparing outcomes between those receiving venous blood cardioplegia with controlled oxygen exposure and those undergoing standard hyperoxic procedures. The findings indicate a significant reduction in mortality, improved ventricular function, lower readmission rates for heart failure, and reduced need for defibrillators.

Evaluating the Need for Magnesium Administration Following Cardioplegic Arrest with Del Nido Cardioplegia Solution

March 11, 2025 No Comments

This study evaluates whether magnesium administration is necessary following cardioplegic arrest with del Nido cardioplegia (dNC) solution at Cincinnati Children’s Hospital Medical Center (CCHMC). Analyzing serum magnesium levels in 100 patients, results showed hypermagnesemia in most cases. Given the potential risks of excessive magnesium, findings suggest eliminating routine post-cross-clamp magnesium administration in dNC settings.

Microvascular Dysfunction Following Cardioplegic Arrest and Cardiopulmonary Bypass: Impacts of Diabetes and Hypertension

March 10, 2025 No Comments

This review examines microvascular dysfunction following cardioplegic arrest and cardiopulmonary bypass (CP/CPB), with a focus on diabetes and hypertension. It explores endothelial and vasomotor dysfunction, gene/protein expression changes, endothelial adherens junction impairment, and programmed cell death. The study highlights the role of oxidative stress, inflammation, and metabolic disruptions, providing insight into potential pharmacological interventions for improving surgical outcomes.

Efficacy and Safety of the Blood-Based Cardioplegia Solution Huaxi-1 in Cardiopulmonary Bypass Surgery: Protocol for a Multicentre Randomised Controlled Trial

February 20, 2025 No Comments

This study evaluates the safety and efficacy of the Huaxi-1 blood-based cardioplegia solution compared to the widely used HTK solution in cardiopulmonary bypass surgery. A randomized, multicenter trial involving 160 adult patients across four hospitals in China will measure myocardial injury markers, cardiac function, and post-surgical recovery. The goal is to establish Huaxi-1’s viability as a standardized cardioplegia solution for improved myocardial protection.

Surgical Outcomes Stratified by Type of Transportation and Presence of Coronary Reperfusion in Patients with Coronary Malperfusion Caused by Type A Aortic Dissection

February 7, 2025 No Comments

This study examines surgical outcomes in patients with Type A acute aortic dissection (AAAD) complicated by coronary malperfusion, focusing on transportation type and clinical management. Analyzing 70 cases, researchers found no significant mortality differences between direct transfers and referrals. However, preoperative extracorporeal membrane oxygenation (ECMO) was not a definitive solution. Diagnostic-only coronary angiography (CAG) without successful reperfusion posed a higher fatality risk, especially with left coronary artery involvement.

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

Del Nido Cardioplegia in Adult Cardiac Surgery: A Narrative Review

Comparison of Del Nido and Histidine-Tryptophan-Ketoglutarate Cardioplegia Solutions: An Animal Study With Prolonged Ischaemia

Cerebral Inflammation in an Animal Ischemia–Reperfusion Model Comparing Histidine-Tryptophan–Ketoglutarate and Del Nido Cardioplegia

Buckberg vs. Del Nido in Isolated Aortic Valve Replacement: A Prospective, Two-Center, Randomized Trial

Gradual Oxygen Exposure During Coronary Bypass for Acute Myocardial Infarction: A Retrospective Cohort Study

Evaluating the Need for Magnesium Administration Following Cardioplegic Arrest with Del Nido Cardioplegia Solution

Microvascular Dysfunction Following Cardioplegic Arrest and Cardiopulmonary Bypass: Impacts of Diabetes and Hypertension

Efficacy and Safety of the Blood-Based Cardioplegia Solution Huaxi-1 in Cardiopulmonary Bypass Surgery: Protocol for a Multicentre Randomised Controlled Trial

Surgical Outcomes Stratified by Type of Transportation and Presence of Coronary Reperfusion in Patients with Coronary Malperfusion Caused by Type A Aortic Dissection

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