Single-Dose Lignocaine-Based Blood Cardioplegia in Single Valve Replacement Patients
Abstract OBJECTIVE: Myocardial protection is the most important in cardiac surgery. We compared our modified single-dose long-acting lignocaine-based blood cardioplegia with short-acting St Thomas 1 blood cardioplegia in patients undergoing single valve replacement. METHODS: A total of 110 patien...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Cirurgia Cardiovascular
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| Series: | Brazilian Journal of Cardiovascular Surgery |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382017000200090&lng=en&tlng=en |
| _version_ | 1818231642729218048 |
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| author | Jaydip Ramani Amber Malhotra Vivek Wadhwa Pranav Sharma Pankaj Garg Malkesh Tarsaria Himani Pandya |
| author_facet | Jaydip Ramani Amber Malhotra Vivek Wadhwa Pranav Sharma Pankaj Garg Malkesh Tarsaria Himani Pandya |
| author_sort | Jaydip Ramani |
| collection | DOAJ |
| description | Abstract OBJECTIVE: Myocardial protection is the most important in cardiac surgery. We compared our modified single-dose long-acting lignocaine-based blood cardioplegia with short-acting St Thomas 1 blood cardioplegia in patients undergoing single valve replacement. METHODS: A total of 110 patients who underwent single (aortic or mitral) valve replacement surgery were enrolled. Patients were divided in two groups based on the cardioplegia solution used. In group 1 (56 patients), long-acting lignocaine based-blood cardioplegia solution was administered as a single dose while in group 2 (54 patients), standard St Thomas IB (short-acting blood-based cardioplegia solution) was administered and repeated every 20 minutes. All the patients were compared for preoperative baseline parameters, intraoperative and all the postoperative parameters. RESULTS: We did not find any statistically significant difference in preoperative baseline parameters. Cardiopulmonary bypass time were 73.8±16.5 and 76.4±16.9 minutes (P=0.43) and cross clamp time were 58.9±10.3 and 66.3±11.2 minutes (P=0.23) in group 1 and group 2, respectively. Mean of maximum inotrope score was 6.3±2.52 and 6.1±2.13 (P=0.65) in group 1 and group 2, respectively. We also did not find any statistically significant difference in creatine-phosphokinase-MB (CPK-MB), Troponin-I levels, lactate level and cardiac functions postoperatively. CONCLUSION: This study proves the safety and efficacy of long-acting lignocaine-based single-dose blood cardioplegia compared to the standard short-acting multi-dose blood cardioplegia in patients requiring the single valve replacement. Further studies need to be undertaken to establish this non-inferiority in situations of complex cardiac procedures especially in compromised patients. |
| first_indexed | 2024-12-12T10:53:38Z |
| format | Article |
| id | doaj.art-00301636487540b7985dd1a8e3661325 |
| institution | Directory Open Access Journal |
| issn | 1678-9741 |
| language | English |
| last_indexed | 2024-12-12T10:53:38Z |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| record_format | Article |
| series | Brazilian Journal of Cardiovascular Surgery |
| spelling | doaj.art-00301636487540b7985dd1a8e36613252022-12-22T00:26:42ZengSociedade Brasileira de Cirurgia CardiovascularBrazilian Journal of Cardiovascular Surgery1678-9741322909510.21470/1678-9741-2016-0025S0102-76382017000200090Single-Dose Lignocaine-Based Blood Cardioplegia in Single Valve Replacement PatientsJaydip RamaniAmber MalhotraVivek WadhwaPranav SharmaPankaj GargMalkesh TarsariaHimani PandyaAbstract OBJECTIVE: Myocardial protection is the most important in cardiac surgery. We compared our modified single-dose long-acting lignocaine-based blood cardioplegia with short-acting St Thomas 1 blood cardioplegia in patients undergoing single valve replacement. METHODS: A total of 110 patients who underwent single (aortic or mitral) valve replacement surgery were enrolled. Patients were divided in two groups based on the cardioplegia solution used. In group 1 (56 patients), long-acting lignocaine based-blood cardioplegia solution was administered as a single dose while in group 2 (54 patients), standard St Thomas IB (short-acting blood-based cardioplegia solution) was administered and repeated every 20 minutes. All the patients were compared for preoperative baseline parameters, intraoperative and all the postoperative parameters. RESULTS: We did not find any statistically significant difference in preoperative baseline parameters. Cardiopulmonary bypass time were 73.8±16.5 and 76.4±16.9 minutes (P=0.43) and cross clamp time were 58.9±10.3 and 66.3±11.2 minutes (P=0.23) in group 1 and group 2, respectively. Mean of maximum inotrope score was 6.3±2.52 and 6.1±2.13 (P=0.65) in group 1 and group 2, respectively. We also did not find any statistically significant difference in creatine-phosphokinase-MB (CPK-MB), Troponin-I levels, lactate level and cardiac functions postoperatively. CONCLUSION: This study proves the safety and efficacy of long-acting lignocaine-based single-dose blood cardioplegia compared to the standard short-acting multi-dose blood cardioplegia in patients requiring the single valve replacement. Further studies need to be undertaken to establish this non-inferiority in situations of complex cardiac procedures especially in compromised patients.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382017000200090&lng=en&tlng=enCardiopulmonary BypassCardioplegic SolutionsLidocaineHeart Valves/SurgeryAortic Valve/SurgeryMitral Valve/sSurgery |
| spellingShingle | Jaydip Ramani Amber Malhotra Vivek Wadhwa Pranav Sharma Pankaj Garg Malkesh Tarsaria Himani Pandya Single-Dose Lignocaine-Based Blood Cardioplegia in Single Valve Replacement Patients Brazilian Journal of Cardiovascular Surgery Cardiopulmonary Bypass Cardioplegic Solutions Lidocaine Heart Valves/Surgery Aortic Valve/Surgery Mitral Valve/sSurgery |
| title | Single-Dose Lignocaine-Based Blood Cardioplegia in Single Valve Replacement Patients |
| title_full | Single-Dose Lignocaine-Based Blood Cardioplegia in Single Valve Replacement Patients |
| title_fullStr | Single-Dose Lignocaine-Based Blood Cardioplegia in Single Valve Replacement Patients |
| title_full_unstemmed | Single-Dose Lignocaine-Based Blood Cardioplegia in Single Valve Replacement Patients |
| title_short | Single-Dose Lignocaine-Based Blood Cardioplegia in Single Valve Replacement Patients |
| title_sort | single dose lignocaine based blood cardioplegia in single valve replacement patients |
| topic | Cardiopulmonary Bypass Cardioplegic Solutions Lidocaine Heart Valves/Surgery Aortic Valve/Surgery Mitral Valve/sSurgery |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382017000200090&lng=en&tlng=en |
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