Evidence map›Paper›PMID 41730659›Full record

ArticleAnnals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia2026

Safety of Custodiol for Myocardial Protection in Minimally Invasive Mitral Valve Repair: A Japanese Single-Center Retrospective Comparison with Blood Cardioplegia in Conventional Sternotomy Repair.

Hiroaki Aizawa, Akihiro Yoshitake, Yuki Katsunori, Osamu Kinoshita, Yu Kumagai, Taro Kuroda, Yuta Kanazawa, Yuko Gatate, Takayuki Gyoten, Toshihisa Asakura

Abstract readComparative Study
In one paragraph

Article in Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia, 2026. 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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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Hiroaki AizawaDepartment of Cardiovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.ORCID http://orcid.org/0009-0002-0530-9755
Akihiro YoshitakeDepartment of Cardiovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.ORCID http://orcid.org/0000-0002-5122-3875
Yuki KatsunoriDepartment of Clinical Engineering, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
Osamu KinoshitaDepartment of Cardiovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
Yu KumagaiDepartment of Cardiovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
Taro KurodaDepartment of Cardiovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
Yuta KanazawaDepartment of Cardiovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
Yuko GatateDepartment of Cardiovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
Takayuki GyotenDepartment of Cardiovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
Toshihisa AsakuraDepartment of Cardiovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeResearch regarding Custodiol's safety in minimally invasive mitral valve repair remains limited in Asian populations. We compared Custodiol in minimally invasive mitral valve repair to repetitive cold blood cardioplegia in open mitral valve repair.

methodsWe retrospectively evaluated 98 consecutive patients who underwent minimally invasive mitral valve repair with Custodiol and 70 consecutive patients who underwent open mitral valve repair with repetitive cold blood cardioplegia at our institution between January 2015 and December 2024. The primary endpoints were creatine kinase-myocardial band (MB) levels and left ventricular ejection fraction determined by echocardiography pre- and post-surgery.

resultsMaximum creatine kinase-MB levels within 48 h post-surgery were significantly lower in the minimally invasive group than in the open repair group, both in the overall cohort (45.0 vs. 60.7 U/L; p <0.001, respectively) and after excluding patients who underwent Maze procedure or pulmonary vein isolation (42.4 vs. 50.0 U/L; p = 0.009, respectively). Left ventricular ejection fraction pre- and post-surgery was comparable between the minimally invasive and open repair groups (72% vs. 69%; p = 0.426 and 59% vs. 60%; p = 0.204, respectively).

conclusionCustodiol during minimally invasive mitral valve repair provides myocardial protection comparable to repetitive cold blood cardioplegia in open mitral valve repair.

Indexed as

Cardioplegic SolutionsHeart Arrest, InducedHeart Valve Prosthesis ImplantationMinimally Invasive Surgical ProceduresMitral Valve AnnuloplastyMitral Valve InsufficiencySternotomyAgedBiomarkersCreatine Kinase, MB FormEast Asian PeopleFemaleGlucoseHumansJapanMaleBiomarkersBretschneider cardioplegic solutionCardioplegic SolutionsCreatine Kinase, MB FormGlucoseMannitolPotassium ChlorideProcaineSodium BicarbonateBretschneider HTK solutionCustodiol cardioplegiaminimally invasive mitral valve repairmyocardial protection

Identifiers

PMID41730659
PMCPMC12950296

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.