E-resources
-
Timek, Tomasz; Willekes, Charles; Hulme, Olivia; Himelhoch, Ben; Nadeau, Daniel; Borgman, Andrew; Clousing, Jeff; Kanten, Dick; Wagner, Joe
The Annals of thoracic surgery, 06/2016, Volume: 101, Issue: 6Journal Article
Del Nido cardioplegia (DC) offers prolonged cardiac protection with single-dose administration and has had a long safety record in pediatric cardiac surgery. However, its application in the adult population has thus far been limited. We evaluated the efficacy of cardiac protection and clinical outcomes of DC vs blood cardioplegia (BC) in adult coronary artery bypass graft (CABG) patients. Clinical outcomes of 100 consecutive isolated CABG patients who received DC (May to September 2014) were compared with the previous 100 consecutive isolated CABG patients receiving BC (December 2013 to April 2014). Propensity matching yielded 82 pairs. The same surgeons operated on all patients. Clinical patient characteristics and data were extracted from our local The Society of Thoracic Surgeons database and the electronic medical record. Preoperative characteristics were similar between BC and DC patients before and after propensity matching. BC patients received anterograde and retrograde cardioplegia, whereas DC was delivered anterograde, with 92 of 100 patients receiving a single dose only. Inotropic support upon arrival to the recovery unit did not differ between BC and DC (0.28 ± 0.11 vs 0.27 ± 0.11 μg/kg/min milrinone p = 0.8 and 0.05 ± 0.03 vs 0.05 ± 0.03 μg/kg/min norepinephrine p = 0.7), nor did postoperative troponin T levels (0.56 ± 0.48 vs 0.70 ± 1.27 ng/mL; p = 0.3). The peak intraoperative glucose level was higher in BC (209.8 ± 40.4 mg/dL) than in DC (161.4 ± 42.3 mg/dL) patients (p < 0.001). No patients died in either group, and the postoperative incidence of atrial fibrillation, stroke, reoperation for bleeding, and prolonged intubation did not differ between the groups before and after matching. There was also no difference in the postoperative ejection fraction between the groups (0.51 ± 0.13 vs 0.47 ± 0.13 for BC and DC, respectively; p = 0.17). In our initial experience, DC provided equivalent myocardial protection and clinical outcomes to BC in adult isolated CABG patients. DC was associated with lower cardiopulmonary bypass glucose levels than BC and demonstrated the feasibility of single-dose administration for routine coronary operations.
Author
Shelf entry
Permalink
- URL:
Impact factor
Access to the JCR database is permitted only to users from Slovenia. Your current IP address is not on the list of IP addresses with access permission, and authentication with the relevant AAI accout is required.
Year | Impact factor | Edition | Category | Classification | ||||
---|---|---|---|---|---|---|---|---|
JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
Select the library membership card:
If the library membership card is not in the list,
add a new one.
DRS, in which the journal is indexed
Database name | Field | Year |
---|
Links to authors' personal bibliographies | Links to information on researchers in the SICRIS system |
---|
Source: Personal bibliographies
and: SICRIS
The material is available in full text. If you wish to order the material anyway, click the Continue button.