Celsior Versus Microplegia: Analysis of Myocardial Protection in Elective Aortic Valve Replacement

Myocardial protection in on-pump coronary artery bypass grafting surgery: analysis of the effectiveness of the use of retrograde Celsior®

“…Also, there are some reports dealing with the use of Celsior® as a crystalloid cardioplegia. [4][5][6] Nowadays, Celsior® is considered as an organ protection solution, with a proven cardioprotective effect in the field of heart transplantation, 3,[25][26][27][28] although its use as a cardioplegic solution has not been deeply studied. One of the possible advantages with the use of crystalloid Celsior® is that it is a simple and effective alternative, using an easily available product, and it has some potential advantages over Custodiol® or Del Nido cardioplegia.…”

“…Nowadays, it has become our standard myocardial protection strategy. 6 In this report, we analyzed the effectiveness of the myocardial protective effect of Celsior®, when used as a single-dose retrograde crystalloid cardioplegia. Our findings show that the postoperative elevation of markers of myocardial damage (TnT) is even lower when compared with microplegia, after the statistical adjustment for several possible confounding factors using PS matching.…”

Microplegia in cardiac surgery: Systematic review and meta‐analysis

“…We used a 5% level of significance and 95% confidence intervals (CIs); figures were produced using CMA. Funnel plots were used to analyse pub- The eleven studies 6,[8][9][10][11][13][14][15][16][17][18] included in the analysis had an aggregate of 5684 participants, 2681 of whom were microplegia patients versus 3003 who received other types of cardioplegia. The characteristics of the included studies are summarized in Table 1.…”

“…In the two trials by Lopez Menendez et al, 13,14 the volume of crystalloids in the microplegia was not given but reported to be "minimal. −422.93, −370.62; I 2 = 94.07%; P < .001) ( Figure S1).…”

Reply

“…I would like to thank Cakir and colleagues [1] for their insightful comments on our article [2], but I should point out that we selected a homogenous population (isolated aortic valve replacement) to avoid as many confounders as possible inherent to observational studies. Regarding left ventricular wall thickness, I completely agree that it has an important role on myocardial protection.…”