scholarly journals Antegrade Intermittent Cold Cardioplegia in Comparison to Antegrade Intermittent Warm Cardioplegia in Heart Valve Surgery

2020 ◽  
Author(s):  
Haitham Abdel-bakey ◽  
Ahmed Elminshawy ◽  
Ahmed Ghoneim ◽  
Ahmed Taha
Keyword(s):  
Heart Valve ◽  
Valve Surgery ◽  
Controlled Study ◽  
Heart Valve Surgery ◽  
Ischemic Time ◽  
Blood Cardioplegia ◽  
Significant Difference ◽  
Warm Blood ◽  
Cold Cardioplegia ◽  
Warm Blood Cardioplegia

Background: The cardioplegic arrest is essential for motionless and bloodless heart valve surgery. The objective of this work was to compare antegrade cold versus warm blood cardioplegia during valve surgery. Methods: This randomized controlled study included 100 patients who had mitral valve surgery. Patients were randomly assigned into two groups; the warm cardioplegic group (n= 50) and the cold cardioplegic group (n= 50). Study endpoints were creatine kinase myocardial band, lactate dehydrogenase, and troponin levels. Results: There was no significant difference in age and sex between groups (p= 0.51 and 0.56, respectively). Cardiopulmonary bypass was significantly longer in the cold group (85.66 ± 22.9 vs. 72.34 ± 25.09 minutes; P= 0.01); however, there was no difference in ischemic time (p= 0.32). The number of DC shocks given for each patient is less in the warm group with a median of 1.5 (range 1-3 times), while in the cold group, the median was 2 (range 2-4 times); p= 0.02. The amount of blood loss was significantly lower among the warm group (645.4 ± 464.93 ml vs. 404 ± 252.7 P< 0.01). warm group had significantly lower postoperative CK (532.78 ± 249.08 vs. 638.14 ± 344.01 IU/L; P< 0.01), CK-MB (78.64 ± 34.58 vs.  103.18 ± 82.11; P< 0.0.01), LDH level (805.3 ± 322.71 vs. 1060.88 ± 500.94 mg/dl; P< 0.01) and (0.4148 ± 0.226 vs. 0.6404 ± 0.411 ng/ml; P< 0.01).   Conclusion: Antegrade warm blood cardioplegia may provide better myocardial protection during valve surgery compared to the cold cardioplegia. A larger study is recommended.

scholarly journals Effects of Del Nido and Terminal Warm Blood Cardioplegia on Myocardial Protection and Rhythm in Isolated CABG Patients

2021 ◽  
Vol 24 (5) ◽  
pp. E808-E813
Author(s):  
Kemal Karaarslan ◽  
Burcin Abud
Keyword(s):  
Myocardial Protection ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Coronary Bypass ◽  
Ischemic Time ◽  
Blood Cardioplegia ◽  
Significant Difference ◽  
Warm Blood ◽  
Warm Blood Cardioplegia ◽  
Cabg Patients

Objective: To investigate the effect of using del Nido cardioplegia+terminal hot-shot blood cardioplegia on myocardial protection and rhythm in isolated coronary bypass patients. Material and methods: A total of 122 patients were given cold (+4-8C') del Nido cardioplegia antegrade and evaluated. Del Nido+terminal warm blood cardioplegia (TWBCP) was applied to 63 patients out of 122 patients, while del Nido cardioplegia alone was applied to the other 59 patients. The preoperative and postoperative data of the patients were recorded and compared. Results: There was a significant statistical difference between the groups, in terms of volume with more cardioplegia in the del Nido+terminal warm blood cardioplegia group. Although there was no significant difference between cardiac arrest times in both groups, a statistically significant difference was found in the del Nido+terminal warm blood cardioplegia group in the starting to work time of the heart. No difference found between the groups regarding myocardial preservation. Conclusions: We can add a return to spontaneous sinus rhythm to the advantages of terminal warm blood cardioplegia and del Nido cardioplegia in literature. We think it would be a good strategy to extend the safe ischemic time limit of del Nido to 120 minutes with a terminal warm blood cardioplegia. It seems that cardioplegia techniques that will be developed by adding the successful and superior results of crystalloid cardioplegia applications, such as single dose del Nido in various open heart surgery operations and the superior myocardial return effects of terminal warm blood cardioplegia, will be used routinely in the future.

scholarly journals Continuous retrograde blood cardioplegia is associated with lower hospital mortality after heart valve surgery

2003 ◽  
Vol 125 (1) ◽  
pp. 121-125 ◽  
Author(s):  
Willem J. Flameng ◽  
Paul Herijgers ◽  
Sarah Dewilde ◽  
Emmanuel Lesaffre
Keyword(s):  
Hospital Mortality ◽  
Heart Valve ◽  
Valve Surgery ◽  
Heart Valve Surgery ◽  
Blood Cardioplegia

Intermittent Warm Blood Cardioplegia in Aortic Valve Surgery: An Update

2007 ◽  
pp. 181-188
Author(s):  
M. Saadah Suleiman ◽  
Raimondo Ascione ◽  
Gianni D. Angelini
Keyword(s):  
Aortic Valve ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Blood Cardioplegia ◽  
Warm Blood ◽  
Warm Blood Cardioplegia

How to Protect Hypertrophied Myocardium? A Prospective Clinical Trial of three Preservation Techniques

1997 ◽  
Vol 20 (8) ◽  
pp. 440-446 ◽  
Author(s):  
F Bouchart ◽  
J.P. Bessou ◽  
A. Tablet ◽  
B. Hecketsweiller ◽  
D. Mouton-Schleifer ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Heart Surgery ◽  
Ventilatory Support ◽  
Lactate Production ◽  
Blood Cardioplegia ◽  
Hypertrophied Myocardium ◽  
Significant Difference ◽  
Cold Blood ◽  
Warm Blood ◽  
Warm Blood Cardioplegia

Protection of the hypertrophied myocardium during heart surgery is still a controversial matter. We prospectively studied 3 currently available preservation techniques in 60 patients operated on for isolated aortic stenosis. Patients were randomly assigned to one of the following groups: CWB: continuous warm blood cardioplegia ICB: intermittent cold blood with warm blood controlled reperfusion Cryst: intermittent cold crystalloid cardioplegia (SLF11, Biosédra Laboratory, Vernon, France). All groups were matched for age, ejection fraction, NYHA class, aortic valve surface, and operative risk score. There were no deaths. No statistically significant difference was found among the groups in terms of ventilatory support time, ICU stay time, hospitalization or atrial fibrillation occurrence. Blood gases in the coronary sinus at the time of clamp release showed deep acidosis with crystalloid cardioplegia (pH = 7.11 vs 7.39 for CWB and 7.38 for UCB, p < 0.0001) associated with a higher lactate production than in the other groups (1.3 mmol vs 0.5 for CWB and 0.58 for ICB, p < 0.0001). Acidosis was corrected at the end of bypass with no significant differences among groups. CK-MB samples were taken on arrival in ICU, then 6 and 24 hours later. These samples showed much higher levels with cold blood (H6: 70 mcg/l vs 33 for CWB and 45 for Cryst, p = 0.0019). Although the 3 types of cardioplegia may be safely used for isolated aortic stenosis surgery, continuous warm blood cardioplegia appears to be the best choice.

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