ArticleKardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery2023
Do we correctly calculate doses of cardioplegia during aortic valve replacement procedures? A preliminary report.
Article in Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Intraoperative myocardial protection during aortic valve replacement (AVR) for aortic stenosis (AS) is of paramount importance for outcomes. The dose of cardioplegia is usually calculated with reference to body mass. Aim: To assess whether such a strategy should be applied to all AS patients undergoing AVR. Material and methods: The study included 94 patients who underwent elective isolated AVR in cardiopulmonary bypass with cold cardioplegic arrest, with a mean age of 65.4 ±7.8 years. They were divided into two subgroup: A with an infusion of high (above median) and subgroup B with a low (below median) volume of cardioplegia indexed for left ventricular mass (LVM). Their doses were referred to the maximal postoperative release of cardiac troponin I (cTnI max). Eventually, it was examined whether the extent of intraoperative myocardial injury translated into long-term survival stratified according to the Kaplan-Meier method. Results: The mean volume of cardioplegia was 1381 ±279 ml (4.9 ±1.6 ml/g of LV myocardium). cTnI max was much higher in group A than in group B (medians: 14.918 vs. 9.876 μg/l; Conclusions: Calculating cardioplegic doses during AVR solely based on body mass may be suboptimal and have a significant impact on postoperative outcomes.
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