Complex valve operations: Antegrade versus retrograde cardioplegia?

Chitwood, W. Randolph; Wixon, Christopher L.; Norton, Terry O.; Lust, Robert M.

doi:10.1016/0003-4975(95)00231-9

Cited by 9 publications

(10 citation statements)

References 10 publications

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“…The operative mortality of RMVS patients over the age of 70 has been found to be 14 % [8]. Parsonnet and colleagues predicted an operative mortality of at least 17 % for patients aged more than 70 years undergoing redo valve surgery [9]. Their study demonstrated that patients aged more than 60 had a significantly poorer long-term survival, although operative mortality was low.…”

Section: Discussionmentioning

confidence: 99%

Determinants of Hospital Mortality after Repeat Mitral Valve Surgery for Rheumatic Mitral Valve Disease

Albeyoğlu

Filizcan²,

Sarğın³

et al. 2006

Thorac cardiovasc Surg

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Section: Discussionmentioning

confidence: 99%

Determinants of Hospital Mortality after Repeat Mitral Valve Surgery for Rheumatic Mitral Valve Disease

Albeyoğlu

Filizcan²,

Sarğın³

et al. 2006

Thorac cardiovasc Surg

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“…3,5 In contrast, our study shows a clear influence of the type of cardioprotection on hospital mortality in valve procedures and combined valve and coronary bypass procedures. This was indicated by the findings of Chitwood and colleagues, 19 who described, in an uncontrolled study of 194 patients undergoing complex cardiac procedures, a 30-day mortality rate of 3.1% with combined antegrade and retrograde cold blood cardioplegia.…”

Section: Discussionmentioning

confidence: 94%

Continuous retrograde blood cardioplegia is associated with lower hospital mortality after heart valve surgery

Flameng

Herijgers

Dewilde

et al. 2003

The Journal of Thoracic and Cardiovascular Surgery

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“…Previous experimental and clinical studies have shown conflicting results regarding the outcome of retrograde coronary sinus blood cardioplegia. Several studies in the early 1990s suggested that retrograde coronary sinus blood cardioplegia may provide optimal myocardial protection [ 5 ]. However, the myocardial protection provided retrograde blood cardioplegia was proven to be inferior to that provided by antegrade blood cardioplegia, based on the assessment of biochemical markers and metabolic responses [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Several studies in the early 1990s suggested that retrograde coronary sinus blood cardioplegia may provide optimal myocardial protection [ 5 ]. However, the myocardial protection provided retrograde blood cardioplegia was proven to be inferior to that provided by antegrade blood cardioplegia, based on the assessment of biochemical markers and metabolic responses [ 5 , 6 ]. The complexity of these results was mostly due to the small numbers of patients studied as well as the heterogeneous techniques and operative procedures employed in these studies [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…The complexity of these results was mostly due to the small numbers of patients studied as well as the heterogeneous techniques and operative procedures employed in these studies [ 7 , 8 ]. Moreover, previous studies have not demonstrated any differences in clinical outcome when antegrade blood cardioplegia is compared to retrograde cardioplegia or antegrade crystalloid cardioplegia [ 5 – 8 ]. This study aimed to compare the clinical efficacy of these three different methods of myocardial protection in the treatment of aortic stenosis.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Results of Different Myocardial Protection Techniques in Aortic Stenosis

Lee

Jeong

Sung

et al. 2015

Korean J Thorac Cardiovasc Surg

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BackgroundHypertrophied myocardium is especially vulnerable to ischemic injury. This study aimed to compare the early and late clinical outcomes of three different methods of myocardial protection in patients with aortic stenosis.MethodsThis retrospective study included 225 consecutive patients (mean age, 65±10 years; 123 males) with severe aortic stenosis who underwent aortic valve replacement. Patients were excluded if they had coronary artery disease, an ejection fraction <50%, more than mild aortic regurgitation, or endocarditis. The patients were divided into three groups: group A, which was treated with antegrade and retrograde cold blood cardioplegia; group B, which was treated with antegrade crystalloid cardioplegia using histidine-tryptophan-ketoglutarate (HTK) solution; and group C, treated with retrograde cold blood cardioplegia.ResultsGroup A contained 70 patients (31.1%), group B contained 74 patients (32.9%), and group C contained 81 patients (36%). The three groups showed significant differences with regard to the proportion of patients with a New York Heart Association functional classification ≥III (p=0.035), N-terminal pro-brain natriuretic peptide levels (p=0.042), ejection fraction (p=0.035), left ventricular dimensions (p<0.001), left ventricular mass index (p<0.001), and right ventricular systolic pressure (p<0.001). Differences in cardiopulmonary bypass time (p=0.532) and aortic cross-clamp time (p=0.48) among the three groups were not statistically significant. During postoperative recovery, no significant differences were found regarding the use of inotropes (p=0.328), mechanical support (n=0), arrhythmias (atrial fibrillation, p=0.347; non-sustained ventricular tachycardia, p=0.1), and ventilator support time (p=0.162). No operative mortality occurred. Similarly, no significant differences were found in long-term outcomes.ConclusionAlthough the three groups showed some significant differences with regard to patient characteristics, both antegrade crystalloid cardioplegia with HTK solution and retrograde cold blood cardioplegia led to early and late clinical results similar to those achieved with combined antegrade and retrograde cold blood cardioplegia.

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Complex valve operations: Antegrade versus retrograde cardioplegia?

Cited by 9 publications

References 10 publications

Determinants of Hospital Mortality after Repeat Mitral Valve Surgery for Rheumatic Mitral Valve Disease

Determinants of Hospital Mortality after Repeat Mitral Valve Surgery for Rheumatic Mitral Valve Disease

Continuous retrograde blood cardioplegia is associated with lower hospital mortality after heart valve surgery

Clinical Results of Different Myocardial Protection Techniques in Aortic Stenosis

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