Alternative technique of long acting cardioplegia delivery results in less hemodilution

Ong, Geok Seen; Guim, Goh Si; Lim, Qi Xuan; Chay-Nancy, Huang Shoo; Jaafar, Nurdiyana Binte; Lim, Clara Anne; Clement, Chew Kai Hong; Sazzad, Faizus; Kofidis, Theo

doi:10.1177/0267659120946727

Cited by 3 publications

(3 citation statements)

References 15 publications

(13 reference statements)

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“…The data were derived from clinically indicated procedures; the choice of procedure and use of DNC or STC was dependent on the surgeon’s preference. The use of STC had a repeat dose every 15–20 min, whereas, for DNC, a modified cardioplegia solution that has been previously described by our group 22 was used for a longer duration of myocardial protection.…”

Section: Methodsmentioning

confidence: 99%

Non-selective Del Nido and St Thomas cardioplegia in adults: analysis of early clinical experience using propensity matching

Sazzad,

Ong,

Ong

et al. 2023

Therapeutic Advances in Cardiovascular Disease

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Background: Del Nido cardioplegia (DNC) is a single-dose, high potassium, low-volume cardioplegia solution that has grown in favor recently. However, the use of DNC in the Asian population may be associated with certain challenges. Methods: Between January 2017 and April 2022, DNC was used for myocardial protection in this single-center retrospective study. In total, 5731 patients underwent open heart surgeries, where 310 patients received DNC for single or multiple procedures. A total of 307 pair of propensity-matched patients from DNC and cold blood St. Thomas cardioplegia (STC) were compared. Results: In total, 5085 patients with STC and 310 patients with DNC from the cohort were matched, reflecting the initial group sizes before propensity matching. About 307 patient pairs were included in the final analysis after propensity matching with the interest variables. In the STC group, the requirement for an immediate postoperative intra-aortic balloon pump (IABP) was significantly higher [18 (5.9%) in DNC versus 28 (9.1%) in STC, p = 0.021]. A 30-day mortality was comparable between the DNC and STC groups (2.9% versus 3.3%, p = 1.00). Major adverse cardiac events (MACE) (2.6% versus 3.6%, p = 0.648) showed no difference between the groups. In both single and multiple procedure subgroups, there were no statistically significant differences in 30-day mortality and MACE incidences when comparing STC and DNC. Conclusion: The use of DNC in adults is acceptable and adaptable. Comparable clinical outcomes between STC patients and DNC were revealed by our investigation. There were no appreciable differences in 30-day mortality or MACE despite the STC group having a much higher need for immediate postoperative IABP.

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Section: Methodsmentioning

confidence: 99%

Non-selective Del Nido and St Thomas cardioplegia in adults: analysis of early clinical experience using propensity matching

Sazzad,

Ong,

Ong

et al. 2023

Therapeutic Advances in Cardiovascular Disease

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“…The most common rule is re-dosing ½ of the initial DNC dose after 60 minutes of XC if the expected total XC time is > 90 minutes. Many modifications to the re-dosing period or the volume and composition of the second DNC dose can be found in the literature [49][50][51][52]. The authors of the analyzed studies did not always include the protocols for administration and re-dosing of DNC.…”

Section: Questions and Limitations Of The Reviewmentioning

confidence: 99%

“…Eur J Transl Clin Med 2023;6(1):[41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57] …”

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Del Nido cardioplegia versus other contemporary solutions for myocardial protection – a literature review

Brzeska¹,

Karolak²,

Żelechowski³

et al. 2023

Eur J Trans Clin Med

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Myocardial protection is one of the most important factors ensuring patient safety during cardiac surgery with the application of cardiopulmonary bypass. Infusion of cardioplegic solution into the coronary circulation protects the heart and provides a standstill operating field for the surgeon. Cold blood cardioplegia and crystalloid cardioplegia are the two main types of solutions with a long history of use and a large amount of research proving their efficacy and safety. Relatively new del Nido cardioplegia seems to be an interesting alternative. We reviewed the literature comparing del Nido cardioplegia with two other types of cardioplegic solutions. We took into consideration many different clinical and biochemical aspects may indicate the quality of cardioprotection.

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Novel Retractor–Camera System Facilitates Less Traumatic Minimally Invasive Procedures and Declutters the Operation Field

Sazzad,

Ng,

Feng

et al. 2024

Innovations�(Phila)

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Objective: To develop a novel endoscopic system that reduces trauma to the patient and declutters the surgical field for the surgeon in minimally invasive heart valve surgery. Methods: We designed and developed a retractor–camera combination for minimally invasive heart surgery; the cable and camera were connected to the underbelly of the left atrial retractor blade to provide an illuminated, wide-angle view of the mitral valve. We conducted ex vivo, in vivo, and, ultimately, a first-in-man randomized, nonanonymized clinical trial on 20 patients who required minimally invasive mitral valve surgery. Data from the preoperative period and the immediate postoperative period were gathered, and patients were followed for 3 months. Results: Our camera–retractor combo demonstrated safe and efficient exposure and vision in all detailed studies. The total operation time for the intervention group (316.5 ± 65.1 min) was slightly shorter than for the control group (317.5 ± 50.8 min). There was no significant difference in the ability to provide exposure of the mitral valve and surrounding left atrial tissue for both control and test articles. The novel camera–retractor reduced clutter in the operation field substantially and eliminated chest penetration for the camera. We also observed that the camera did not fog, did not stain with blood, and did not require frequent corrections to its position. Conclusions: We launch a novel atrial retraction–imaging platform that is less invasive for the patient and eliminates clutter and redundant movements for the surgeon.

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Alternative technique of long acting cardioplegia delivery results in less hemodilution

Cited by 3 publications

References 15 publications

Non-selective Del Nido and St Thomas cardioplegia in adults: analysis of early clinical experience using propensity matching

Non-selective Del Nido and St Thomas cardioplegia in adults: analysis of early clinical experience using propensity matching

Del Nido cardioplegia versus other contemporary solutions for myocardial protection – a literature review

Novel Retractor–Camera System Facilitates Less Traumatic Minimally Invasive Procedures and Declutters the Operation Field

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