کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
8679114 | 1579114 | 2017 | 28 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Single-dose del Nido Cardioplegia in Minimally Invasive Aortic Valve Surgery
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کلمات کلیدی
موضوعات مرتبط
علوم پزشکی و سلامت
پزشکی و دندانپزشکی
کاردیولوژی و پزشکی قلب و عروق
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چکیده انگلیسی
del Nido cardioplegia (DC) offers prolonged cardiac protection with single-dose administration and has been shown to be safe in adult CABG surgery. We set out to evaluate the efficacy of cardiac protection and clinical outcomes of DC versus standard blood cardioplegia (BC) in minimally invasive aortic valve surgery. From August 2011 to May 2016, 178 patients underwent minimally invasive aortic valve replacement (mini-AVR) with BC (nâ=â101) or DC (nâ=â77). Ministernotomy or right minithoracotomy was utilized for surgical access. Clinical patient characteristics and data were extracted from our local Society of Thoracic Surgeons (STS) database and the electronic medical record. Patients were propensity matched for age, gender, body mass index, valve size and type, STS score, surgical access, preop creatinine, diabetes, and chronic obstructive pulmonary disease, yielding 63 well-matched pairs. There was no difference in patient age, preoperative creatinine, body mass index, diabetes, chronic obstructive pulmonary disease, or STS score between BC and DC before or after propensity matching. BC patients received both anterograde and retrograde cardioplegias in multiple doses, whereas DC was delivered almost entirely anterograde with 95% of the patients (73/77) receiving a single dose only. DC was associated with decreased cardiopulmonary bypass time (108â±â24 vs 135â±â43âminutes, Pâ=â0.001) and aortic cross-clamp time (80â±â16 vs 102â±â30âmin, Pâ=â0.001) and maximal glucose levels during cardiopulmonary bypass (165â±â39 vs 202â±â49âmg/dL, Pâ=â0.001), whereas troponin T level did not differ between DC and BC (0.3â±â0.29 vs 0.44â±â1.7âng/mL, Pâ=â0.7). Preoperative ejection fraction did not change in either BC (64%â±â12% vs 61%â±â10%, Pâ=â0.09) or DC (58%â±â14% vs 57%â±â14%, Pâ=â0.4) after AVR. In minimally invasive AVR surgery, DC provided equivalent myocardial protection and clinical outcomes to BC while simplifying cardioprotective regimen and reducing aortic cross-clamp time. DC was associated with lower cardiopulmonary bypass glucose levels and demonstrated the feasibility of a single-dose administration.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Seminars in Thoracic and Cardiovascular Surgery - Volume 29, Issue 4, Winter 2017, Pages 471-476
Journal: Seminars in Thoracic and Cardiovascular Surgery - Volume 29, Issue 4, Winter 2017, Pages 471-476
نویسندگان
Daniel BS, Regina BS, Ben BS, Andrew MS, Jessica L. MS, Charles L. MD, Tomasz A. MD, PhD,