Comparison of del Nido Cardioplegia with Blood Cardioplegia in Coronary Artery Bypass Grafting Combined with Mitral Valve Replacement
Abstract Objective: To compare del Nido cardioplegia (DNC) with blood cardioplegia (BC) in coronary artery bypass grafting (CABG) combined with mitral valve replacement. Methods: A 3-year single-center retrospective cohort study was carried out. Subjects who underwent CABG (up to triple bypass) co...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Sociedade Brasileira de Cirurgia Cardiovascular
|
| Series: | Brazilian Journal of Cardiovascular Surgery |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382018000500496&lng=en&tlng=en |
| _version_ | 1828214078169939968 |
|---|---|
| author | Ali Aycan Kavala Saygin Turkyilmaz |
| author_facet | Ali Aycan Kavala Saygin Turkyilmaz |
| author_sort | Ali Aycan Kavala |
| collection | DOAJ |
| description | Abstract Objective: To compare del Nido cardioplegia (DNC) with blood cardioplegia (BC) in coronary artery bypass grafting (CABG) combined with mitral valve replacement. Methods: A 3-year single-center retrospective cohort study was carried out. Subjects who underwent CABG (up to triple bypass) combined with mitral valve replacement were divided into DNC and BC groups. Each group had thirty subjects. Results: Both groups demonstrated similar baseline characteristics, including age, gender, cardiac/non-cardiac comorbidity, and preoperative echocardiographic parameters. Compared with the BC group, the DNC group demonstrated significantly lower cardioplegia volume (BC = 1130.00±194.1 mL, DNC = 884.33±156.8 mL, P=0.001), cardiopulmonary bypass time (DNC = 110.90±12.52 min, BC = 121.70±13.57 min, P=0.002), aortic clamp time (DNC = 91.37±11.58 min, BC = 101.37±13.87 min, P=0.004), and need for intraoperative defibrillation (DNC = 6 events, BC = 21 events, P=0.001). Postoperative creatine kinase-MB levels and troponin levels were significantly lower in the DNC group than in the BC group. Postoperative haemoglobin and haematocrit levels were significantly higher in the DNC group than in the BC group. The intubation period (hours) in intensive care unit (ICU) was significantly small in the BC group (DNC = 8.13±12.21, BC = 6.82±1.57, P=0.037); however, ICU stay, total hospital stay, and postoperative complication rates were not significantly different between them. At pre-discharge echocardiography, the DNC group demonstrated significantly higher ejection fraction rates than the BC group (47.79±5.50 and 45.72±5.86, respectively, P=0.005). Conclusion: DNC presented better intraoperative and postoperative parameters and it is an effective and safe alternative to BC for CABG combined with mitral valve replacement. |
| first_indexed | 2024-04-12T14:58:46Z |
| format | Article |
| id | doaj.art-575e0339a164490f8f8a14beecd7b3aa |
| institution | Directory Open Access Journal |
| issn | 1678-9741 |
| language | English |
| last_indexed | 2024-04-12T14:58:46Z |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| record_format | Article |
| series | Brazilian Journal of Cardiovascular Surgery |
| spelling | doaj.art-575e0339a164490f8f8a14beecd7b3aa2022-12-22T03:28:08ZengSociedade Brasileira de Cirurgia CardiovascularBrazilian Journal of Cardiovascular Surgery1678-974133549650410.21470/1678-9741-2018-0152S0102-76382018000500496Comparison of del Nido Cardioplegia with Blood Cardioplegia in Coronary Artery Bypass Grafting Combined with Mitral Valve ReplacementAli Aycan KavalaSaygin TurkyilmazAbstract Objective: To compare del Nido cardioplegia (DNC) with blood cardioplegia (BC) in coronary artery bypass grafting (CABG) combined with mitral valve replacement. Methods: A 3-year single-center retrospective cohort study was carried out. Subjects who underwent CABG (up to triple bypass) combined with mitral valve replacement were divided into DNC and BC groups. Each group had thirty subjects. Results: Both groups demonstrated similar baseline characteristics, including age, gender, cardiac/non-cardiac comorbidity, and preoperative echocardiographic parameters. Compared with the BC group, the DNC group demonstrated significantly lower cardioplegia volume (BC = 1130.00±194.1 mL, DNC = 884.33±156.8 mL, P=0.001), cardiopulmonary bypass time (DNC = 110.90±12.52 min, BC = 121.70±13.57 min, P=0.002), aortic clamp time (DNC = 91.37±11.58 min, BC = 101.37±13.87 min, P=0.004), and need for intraoperative defibrillation (DNC = 6 events, BC = 21 events, P=0.001). Postoperative creatine kinase-MB levels and troponin levels were significantly lower in the DNC group than in the BC group. Postoperative haemoglobin and haematocrit levels were significantly higher in the DNC group than in the BC group. The intubation period (hours) in intensive care unit (ICU) was significantly small in the BC group (DNC = 8.13±12.21, BC = 6.82±1.57, P=0.037); however, ICU stay, total hospital stay, and postoperative complication rates were not significantly different between them. At pre-discharge echocardiography, the DNC group demonstrated significantly higher ejection fraction rates than the BC group (47.79±5.50 and 45.72±5.86, respectively, P=0.005). Conclusion: DNC presented better intraoperative and postoperative parameters and it is an effective and safe alternative to BC for CABG combined with mitral valve replacement.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382018000500496&lng=en&tlng=enMitral Valve/SurgeryCoronary Artery BypassHeart Arrest, InducedCardioplegic SolutionsTreatment Outcome |
| spellingShingle | Ali Aycan Kavala Saygin Turkyilmaz Comparison of del Nido Cardioplegia with Blood Cardioplegia in Coronary Artery Bypass Grafting Combined with Mitral Valve Replacement Brazilian Journal of Cardiovascular Surgery Mitral Valve/Surgery Coronary Artery Bypass Heart Arrest, Induced Cardioplegic Solutions Treatment Outcome |
| title | Comparison of del Nido Cardioplegia with Blood Cardioplegia in Coronary Artery Bypass Grafting Combined with Mitral Valve Replacement |
| title_full | Comparison of del Nido Cardioplegia with Blood Cardioplegia in Coronary Artery Bypass Grafting Combined with Mitral Valve Replacement |
| title_fullStr | Comparison of del Nido Cardioplegia with Blood Cardioplegia in Coronary Artery Bypass Grafting Combined with Mitral Valve Replacement |
| title_full_unstemmed | Comparison of del Nido Cardioplegia with Blood Cardioplegia in Coronary Artery Bypass Grafting Combined with Mitral Valve Replacement |
| title_short | Comparison of del Nido Cardioplegia with Blood Cardioplegia in Coronary Artery Bypass Grafting Combined with Mitral Valve Replacement |
| title_sort | comparison of del nido cardioplegia with blood cardioplegia in coronary artery bypass grafting combined with mitral valve replacement |
| topic | Mitral Valve/Surgery Coronary Artery Bypass Heart Arrest, Induced Cardioplegic Solutions Treatment Outcome |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382018000500496&lng=en&tlng=en |
| work_keys_str_mv | AT aliaycankavala comparisonofdelnidocardioplegiawithbloodcardioplegiaincoronaryarterybypassgraftingcombinedwithmitralvalvereplacement AT sayginturkyilmaz comparisonofdelnidocardioplegiawithbloodcardioplegiaincoronaryarterybypassgraftingcombinedwithmitralvalvereplacement |