Objective Custodiol (R) and St. Thomas cardioplegia are widely employed in mini-thoracotomy mitral valve (MV) operations. One-dose of the former provides 3 h of myocardial protection. Conversely, St. Thomas solution is usually reinfused every 30 min and safety of single delivery is unknown. We aimed to compare single-shot St. Thomas versus Custodiol (R) cardioplegia.Methods Primary endpoint of the prospective observational study was cardiac troponin T level at different post-operative time-points. Propensity-weighted treatment served to adjust for confounding factors.Results Thirty-nine patients receiving St. Thomas were compared with 25 patients receiving Custodiol (R) cardioplegia; cross-clamping always exceeded 45 min. No differences were found in postoperative markers of myocardial injury. Ventricular fibrillation at the resumption of electric activity was more frequent following Custodiol (R) cardioplegia (P = .01).Conclusion Effective myocardial protection exceeding 1 h of ischemic arrest can be achieved with a single-dose St. Thomas cardioplegia in selected patients undergoing right mini-thoracotomy MV surgery.

Single-Dose St. Thomas Versus Custodiol® Cardioplegia for Right Mini-thoracotomy Mitral Valve Surgery / C. Barbero, M. Pocar, G. Marchetto, E. Cura Stura, C. Calia, B. Dalbesio, C. Filippini, S. Salizzoni, M. Boffini, M. Rinaldi, D. Ricci. - In: JOURNAL OF CARDIOVASCULAR TRANSLATIONAL RESEARCH. - ISSN 1937-5395. - 16:(2023), pp. 192-198. [10.1007/s12265-022-10296-z]

Single-Dose St. Thomas Versus Custodiol® Cardioplegia for Right Mini-thoracotomy Mitral Valve Surgery

M. Pocar
Co-primo
;
G. Marchetto;
2023

Abstract

Objective Custodiol (R) and St. Thomas cardioplegia are widely employed in mini-thoracotomy mitral valve (MV) operations. One-dose of the former provides 3 h of myocardial protection. Conversely, St. Thomas solution is usually reinfused every 30 min and safety of single delivery is unknown. We aimed to compare single-shot St. Thomas versus Custodiol (R) cardioplegia.Methods Primary endpoint of the prospective observational study was cardiac troponin T level at different post-operative time-points. Propensity-weighted treatment served to adjust for confounding factors.Results Thirty-nine patients receiving St. Thomas were compared with 25 patients receiving Custodiol (R) cardioplegia; cross-clamping always exceeded 45 min. No differences were found in postoperative markers of myocardial injury. Ventricular fibrillation at the resumption of electric activity was more frequent following Custodiol (R) cardioplegia (P = .01).Conclusion Effective myocardial protection exceeding 1 h of ischemic arrest can be achieved with a single-dose St. Thomas cardioplegia in selected patients undergoing right mini-thoracotomy MV surgery.
Cardiopulmonary bypass; Crystalloid cardioplegia; Minimally invasive surgery; Mitral valve repair; Myocardial protection
Settore MED/23 - Chirurgia Cardiaca
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
2023
8-ago-2022
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/953181
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