The impact of del Nido cardioplegia solution on blood morphology parameters

Perfusion ◽  
2021 ◽  
pp. 026765912110490
Author(s):  
Krzysztof Sanetra ◽  
Wojciech Domaradzki ◽  
Marek Cisowski ◽  
Rajesh Shrestha ◽  
Krzysztof Białek ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Blood Cell ◽  
Valve Replacement ◽  
Transfusion Rate ◽  
Blood Cardioplegia ◽  
Blood Morphology ◽  
Cold Blood ◽  
Cold Blood Cardioplegia ◽  
Morphology Parameters

Background: Crystalloid cardioplegic solutions are believed to reduce hemoglobin significantly and increase the transfusion rate. However, recent reports indicate that the del Nido cardioplegia may preserve blood morphology parameters. Methods: In “The del Nido versus cold blood cardioplegia in aortic valve Replacement” trial patients undergoing aortic valve replacement were randomized into the del Nido (DN) or cold blood cardioplegia (CB) group. For the subanalysis, patients who underwent blood transfusions were excluded from the study. Red blood cell (RBC) count, hemoglobin, white blood cell (WBC) count and platelet (PLT) count were measured before the surgery, 24-, 48-, and 96 hours postoperatively. Furthermore, percental variation in first-last measure was compared in groups. In addition, indexed normalized ratio (INR) and activated partial thromboplastin time (aPTT) were compared preoperatively and 24 hours after the surgery. Results: Eighteen (24%) patients from the del Nido group and 22 (29.3%) patients from the CB group received blood product transfusions (p = 0.560) and were excluded from further analysis. As such, 57 patients remained in DN group and 53 patients remained in CB group. No difference was found in RBC, hemoglobin, WBC, and platelet count in time intervals. Percental variation in first-last measure revealed higher fall in RBC (p = 0.0024) and hemoglobin (p = 0.0028) in the CB group. No difference was shown in preoperative and 24-hour postoperative INR and aPTT. Conclusions: The del Nido cardioplegia does not decrease blood morphology parameters when compared to cold blood cardioplegia and may be used alternatively regardless of bleeding and coagulopathy risk.

The del Nido versus cold blood cardioplegia in aortic valve replacement: A randomized trial

2020 ◽  
Vol 159 (6) ◽  
pp. 2275-2283.e1 ◽  
Author(s):  
Krzysztof Sanetra ◽  
Witold Gerber ◽  
Rajesh Shrestha ◽  
Wojciech Domaradzki ◽  
Łukasz Krzych ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Randomized Trial ◽  
Valve Replacement ◽  
Blood Cardioplegia ◽  
Cold Blood ◽  
Cold Blood Cardioplegia

scholarly journals Outcomes of the minimally invasive aortic valve replacement

2019 ◽  
Vol 178 (3) ◽  
pp. 16-20
Author(s):  
M. A. Snegirev ◽  
A. A. Paivin ◽  
D. O. Denisyuk ◽  
N. E. Khvan ◽  
L. B. Sichinava ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Early Postoperative Period ◽  
Red Blood Cell Transfusion ◽  
Postoperative Blood Loss ◽  
Transfusion Rate ◽  
Results Of Treatment ◽  
Risk Patients

The OBJECTIVE was to demonstrate clinical outcomes of minimally invasive aortic valve replacement (MIAVR).MATERIAL AND METHODS. We retrospectively analyzed surgical results of treatment of patients underwent isolated AVR in our Institution between 2006 and 2018. Overall number of operations was 122; 56 of patient were operated via upper ministernotomy approach. Preoperative characteristics were similar in both groups.RESULTS. In our series MIAVR procedures had prolonged CPB and aortic cross clamping time, what significantly contributed to the increase in manifestations of heart failure in the early postoperative period, but didn’t affect the perioperative mortality and major morbidity rates. MIAVR led to reduction in postoperative blood loss and perioperative red blood cell transfusion rate. Most severe complications occurred in frail patients older than 75 years, and in those with extensive aortic annular calcification.CONCLUSION. MIAVR was the safe and reproducible surgical intervention and rarely led to significant complications in low-risk patients. Prolonged CPB time adversely affected the frequency of significant complications, especially in elderly patients. Although, selected high risk patients might benefit with MIAVR.

Intermittent Antegrade Warm Blood Cardioplegia in Aortic Valve Replacement

1996 ◽  
Vol 11 (5) ◽  
pp. 348-354 ◽  
Author(s):  
Antonio M. Calafiore ◽  
Giovanni Teodori ◽  
Giovanni Bosco ◽  
Gabriele Di Giammarco ◽  
Giuseppe Vitolla ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Blood Cardioplegia ◽  
Warm Blood ◽  
Warm Blood Cardioplegia

scholarly journals Institutional Red Blood Cell Transfusion Rates Are Correlated Following Endovascular and Surgical Cardiovascular Procedures: Evidence That Local Culture Influences Transfusion Decisions

2020 ◽  
Vol 9 (22) ◽  
Author(s):  
Eirini Apostolidou ◽  
Dhaval Kolte ◽  
Kevin F. Kennedy ◽  
Charles E. Beale ◽  
J. Dawn Abbott ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Blood Cell ◽  
Valve Replacement ◽  
Red Blood Cell ◽  
Coronary Revascularization ◽  
Red Blood Cell Transfusion ◽  
Surgical Aortic Valve Replacement ◽  
Vascular Intervention ◽  
Highly Correlated

Background The relationship between local hospital culture and transfusion rates following endovascular and surgical cardiovascular procedures has not been well studied. Methods and Results Patients undergoing coronary revascularization, aortic valve replacement, lower extremity peripheral vascular intervention, or carotid artery revascularization from up to 852 US hospitals in the Nationwide Readmissions Database were identified. Crude and risk‐standardized red blood cell transfusion rates were determined for each procedure. Pearson correlation coefficients were calculated between respective procedural transfusion rates. Median odds ratios were estimated to reflect between‐hospital variability in red blood cell transfusion rates following the same procedure for a given patient. There was wide variation in red blood cell transfusion rates across different procedures, from 2% following carotid endarterectomy to 29% following surgical aortic valve replacement. For surgical and endovascular modalities, transfusion rates at the same hospital were highly correlated for aortic valve replacement ( r =0.67; P <0.001), moderately correlated for coronary revascularization ( r =0.56; P <0.001) and peripheral vascular intervention ( r =0.51; P <0.001), and weakly correlated for carotid artery revascularization ( r =0.19, P <0.001). Median odds ratios were all >2, highest for coronary artery bypass graft surgery and surgical aortic valve replacement, indicating substantial site variation in transfusion rates. Conclusions After adjustment for patient‐related factors, wide variation in red blood cell transfusion rates remained across surgical and endovascular procedures employed for the same cardiovascular condition. Transfusion rates following these procedures are highly correlated at individual hospitals and vary widely across hospitals. In aggregate, these findings suggest that local institutional culture significantly influences the decision to transfuse following invasive cardiovascular procedures and highlight the need for randomized data to inform such decisions.

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