One shot of modified cardioplegia solution in Adults

Abstract

Abstract

Background: The goal of myocardial protection is minimizing the negative effect of myocardial ischemia. Enabling the heart to resume its function adequately after weaning from CPB. Failure of myocardial protection will result in extensive myocardial injury. Which will subsequently result in poor myocardial performance and a need of medical or mechanical support.

Methods: The standard in literature until now is the repeated administration of the blood cardioplegia solution every 20 minutes and that is to maintain the state of asystole and to improve myocardial protection.

In our analyses, we intend to put that standard into test to find out if a single administration of cold blood crystalloid solution is at least comparable to repeated administration of cardioplegia.

 In this analysis, we try to reveal the significance of the single – shot cardioplegia effect on the clinical outcomes namely the occurrence of need of intra operative electric shock, intra operative and post-operative inotropes, intra and extra operative need of intra-aortic balloon pump (IABP), post-operative infarction, arrhythmias, and death.

In addition, we have studied echographic end systolic and diastolic diameters, and pre and post-operative ejection fraction (EF).

Results: We have studied 129 patients underwent open-heart surgery, this study was carried prospective and we have these results.

1. No need of intra-aortic balloon pump in any patient.
2. No need of intra-operative electric shock in almost all of the patients (124 of 129).
3. No need of intra or extra operative inotropes in almost all of the Patients (122 of 129).
4. No infarction was met.
5. Arrhythmias, only 6 patients suffered from atrial fibrillation (5%).
6. There are no deaths.
7. There is a significant improvement in the EF post-operative compared pre-operative (P value =0.0001).
8. There is a significant improve in the end diastolic left ventricle diameter post-operative compared pre-operative (P value =0.0001).
9. There is no difference in the end systolic left ventricle diameter post- operative compared pre-operative.

Conclusion: We have revealed the susperiority of single shot cold-blood crystalloid cardioplegia.