Single-Dose Lignocaine-Based Blood Cardioplegia in Single Valve Replacement Patients

Ramani, Jaydip; Malhotra, Amber; Wadhwa, Vivek K.; Sharma, Pranav; Garg, Pankaj; Tarsaria, Malkesh; Pandya, Himani

doi:10.21470/1678-9741-2016-0025

Cited by 6 publications

(7 citation statements)

References 13 publications

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“…It is a functional MR, commonly coexisting with aortic stenosis (AS). Surgical intervention must be carefully selected because double valve surgery is more associated with increased mortality [2] than isolated aortic valve replacement (AVR). Besides, additional mitral valve intervention during AVR had been long debated, especially for functional MR [1-4] .…”

Section: Introductionmentioning

confidence: 99%

Change in Functional Moderate Mitral Regurgitation after Aortic Valve Replacement

Wang¹,

Wang²,

Piao³

et al. 2019

Braz J Cardiovasc Surg

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ObjectiveTo evaluate the changes of the mitral valve geometrics and the degrees of moderate mitral regurgitation (MR) in patients undergoing aortic valve replacement (AVR) for aortic stenosis (AS).MethodsA retrospective analysis study of intraoperative transesophageal echocardiography (TEE) and postoperative transthoracic echocardiography (TTE) was performed in 49 patients diagnosed with pure AS combined with moderate MR, who underwent AVR from January 2013 to December 2017. TEE was used to evaluate the direct geometric changes of the mechanical effects on mitral annulus after AVR. TTE was used to evaluate the changes of MR after operation. All patients underwent TTE during the midterm follow-up. The mean follow-up time was 40.21 months.ResultsAll of the 49 patients had moderate MR. Anterolateral-posteromedial diameter, anterior-posterior diameter, and mitral annular area were significantly reduced after AVR, while no significant changes were found in the intraoperative left ventricular loading conditions before and after AVR. The degree of mitral valve regurgitation, left ventricular size, left atrial size, left ventricular end-diastolic volume, and left ventricular to aortic pressure gradient were significantly reduced before discharge, and midterm follow-up showed good results.ConclusionThis study supports the belief that aortic outflow tract obstruction and an actual mechanical compression of the anterior mitral annulus after AVR would cause reduction in MR. Ventricular remodeling would also cause reduction in MR with time going on. Patients with AS, especially young patients with moderate MR, were most likely to benefit from AVR in early time.

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Section: Introductionmentioning

confidence: 99%

Change in Functional Moderate Mitral Regurgitation after Aortic Valve Replacement

Wang¹,

Wang²,

Piao³

et al. 2019

Braz J Cardiovasc Surg

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“…There is momentum to incorporate myoprotective methods that extend the safe ischemic time, reducing the need for CP re-dosing 5–7 These techniques increase the time between CP dosing, which may lower cross-clamp times and, ultimately, the time on CPB, both of which are linked to improved outcomes. 8–11 This is especially attractive in patients with valvular lesions where the administration of CP may require the use of specialized delivery cannulae or obscures the operative field, extending ischemic time.…”

Section: Introductionmentioning

confidence: 99%

Does the type of cardioplegia used during valve surgery influence operative nadir hematocrit and transfusion requirements?

et al. 2018

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“…The postoperative indices of left and right ventricular function in this study were comparable to those in other studies on patients with preserved myocardial function. 3…”

Section: Discussionmentioning

confidence: 99%

“…A difference in CK-MB proportion of 0.1 UċL −1 was considered to establish clinical equivalence, based on our previous report. 3…”

Section: Methodsmentioning

confidence: 99%

Normokalemic nondepolarizing long-acting blood cardioplegia

Malhotra

Wadhawa

Ramani

et al. 2017

Asian Cardiovasc Thorac Ann

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Objective Blood cardioplegia, the gold-standard cardioprotective strategy, requires frequent dosing, resulting in hyperkalemia-induced myocardial edema. The aim of our study was to compare the efficacy and safety of a long-acting blood-based cardioplegia with physiological potassium levels versus the well-established cold blood St. Thomas' Hospital no. 1 cardioplegia solution in multivalve surgeries. Methods One hundred patients undergoing simultaneous elective aortic and mitral valve replacement ± tricuspid valve repair were randomized in two groups. In group 1, adenosine 12 mg was given via the aortic root after crossclamping, followed by a single dose of long-acting solution at 14℃ (30 mLċkg); in group 2, an initial 30 mLċkg of St. Thomas' cardioplegia at 14℃ was administered, followed by 15 mLċkg every 20 min. Duration of cardiopulmonary bypass, inotropic score, arrhythmias, ventilation time, and the levels of interleukin-6, creatinine kinase-MB, and troponin I were compared. Results Mean cardiopulmonary bypass and crossclamp times were 134.04 ± 36.12 vs. 154.34 ± 34.26 ( p = 0.004) and 110.37 ± 24.80 vs. 132.48 ± 31.68 min ( p = 0.002), respectively, in the long-acting and St. Thomas' groups. Cardiac index, creatinine kinase-MB and troponin I levels were comparable. Interleukin-6 levels post-bypass were 61.72 ± 15.33 and 75.44 ± 31.78 pgċmL ( p = 0.007) in the long-acting and St. Thomas' cardioplegia groups, respectively. Conclusions Single-dose long-acting cardioplegia gives a cardioprotective effect comparable to repeated doses of the well-established St. Thomas' Hospital no. 1 cold blood cardioplegia.

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Single-Dose Lignocaine-Based Blood Cardioplegia in Single Valve Replacement Patients

Cited by 6 publications

References 13 publications

Change in Functional Moderate Mitral Regurgitation after Aortic Valve Replacement

Change in Functional Moderate Mitral Regurgitation after Aortic Valve Replacement

Does the type of cardioplegia used during valve surgery influence operative nadir hematocrit and transfusion requirements?

Normokalemic nondepolarizing long-acting blood cardioplegia

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