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Vol 18, No 1-2 (2016)
Original articles
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Comparison of myocardial damage following crystalloid and blood cardioplegia in patients undergoing isolated aortic valve replacement

Jakub Palacz, Elżbieta Paszek, Aleksander Wilk, Roman Pfitzner, Wacław Kuczmik
Chirurgia Polska 2016;18(1-2):5-8.

open access

Vol 18, No 1-2 (2016)
Original articles

Abstract

Introduction: Cardioplegia is a procedure used for inducing temporal electromechanical cardiac arrest prior to cardiosurgical procedures. It is a solution characterized by a high potassium concentration that is introduced directly into coronary arteries in two possible forms: mixed with the patient’s oxygenated blood (blood cardioplegia) or as a crystalloid solution (crystalloid cardioplegia). Studies conducted so far have shown the superiority of blood cardioplegia in comparison with crystalloid solution in coronary artery bypass grafting (CABG).

The purpose of this study was to assess whether the type of administered cardioplegia influences the extent of myocardial damage in individuals who underwent an isolated, aortic valve replacement (AVR), similarly to CABG-patients.

Matrial and methods: This is retrospective analysis of 203 post-AVR patients, who received either blood or crystalloid cardioplegia. The parameters compared between the two groups included: post-operative troponin I (TnI) levels, the occurrence of ventricular fibrillation (VF) after aortic cross clamp release, left ventricular ejection fraction (LVEF) and 30-day mortality.

Results: Our study has shown that the post-operative TnI concentration is 41% higher in the group with crystalloid cardioplegia and the relative risk of VF occurrence was 1,5 in this group.

Conclusions: The type of administered cardioplegia may influence the organic and functional condition of the myocardium following a cardiosurgical procedure. In comparison to crystalloid cardioplegia, using blood cardioplegia should be considered a better cardioprotective approach in terms of myocardial injury and conductive system damage.

Abstract

Introduction: Cardioplegia is a procedure used for inducing temporal electromechanical cardiac arrest prior to cardiosurgical procedures. It is a solution characterized by a high potassium concentration that is introduced directly into coronary arteries in two possible forms: mixed with the patient’s oxygenated blood (blood cardioplegia) or as a crystalloid solution (crystalloid cardioplegia). Studies conducted so far have shown the superiority of blood cardioplegia in comparison with crystalloid solution in coronary artery bypass grafting (CABG).

The purpose of this study was to assess whether the type of administered cardioplegia influences the extent of myocardial damage in individuals who underwent an isolated, aortic valve replacement (AVR), similarly to CABG-patients.

Matrial and methods: This is retrospective analysis of 203 post-AVR patients, who received either blood or crystalloid cardioplegia. The parameters compared between the two groups included: post-operative troponin I (TnI) levels, the occurrence of ventricular fibrillation (VF) after aortic cross clamp release, left ventricular ejection fraction (LVEF) and 30-day mortality.

Results: Our study has shown that the post-operative TnI concentration is 41% higher in the group with crystalloid cardioplegia and the relative risk of VF occurrence was 1,5 in this group.

Conclusions: The type of administered cardioplegia may influence the organic and functional condition of the myocardium following a cardiosurgical procedure. In comparison to crystalloid cardioplegia, using blood cardioplegia should be considered a better cardioprotective approach in terms of myocardial injury and conductive system damage.

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Keywords

cardioplegia, aortic valve replacement, induced, heart arrest

About this article
Title

Comparison of myocardial damage following crystalloid and blood cardioplegia in patients undergoing isolated aortic valve replacement

Journal

Chirurgia Polska (Polish Surgery)

Issue

Vol 18, No 1-2 (2016)

Pages

5-8

Bibliographic record

Chirurgia Polska 2016;18(1-2):5-8.

Keywords

cardioplegia
aortic valve replacement
induced
heart arrest

Authors

Jakub Palacz
Elżbieta Paszek
Aleksander Wilk
Roman Pfitzner
Wacław Kuczmik

References (9)
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  8. Carrier M, Pellerin M, Perrault LP, et al. Cardioplegic arrest with L-arginine improves myocardial protection: results of a prospective randomized clinical trial. Ann Thorac Surg. 2002; 73(3): 837–41; discussion 842.
  9. Braathen B, Vengen OA, Tønnessen T. Myocardial cooling with ice-slush provides no cardioprotective effects in aortic valve replacement. Scand Cardiovasc J. 2006; 40(6): 368–373.

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