Use of (All-Blood) Miniplegia Versus Crystalloid Cardioplegia in an Experimental Model of Acute Myocardial Ischemia

Atrial fibrillation (AF) remains a frequent complication after coronary artery bypass graft surgery (CABG). We evaluate the association of AF occurrence and serum cardiac troponin I (cTnI) levels in the early postoperative period after CABG. Between April 2009 and January 2010, 95 consecutive patients with sinus rhythm who underwent CABG were evaluated. The patients were divided into two groups according to their postoperative rhythms: sinus rhythm group (SR) and AF group (AF). Demographic, clinical variables, and troponin I were evaluated at the pre- and postoperative times. There were no clinical or demographic differences between the two groups. The postoperative troponin I in the SR group was lower than that in the AF group (0.66 ± 1.62 vs. 2.07 ± 5.01 ng/ml; P = 0.029). Using the receiver operating characteristic curves was found as the best cut-off value to predict AF occurrence at the value of 0.901 ng/ml. Using this value of cTnI, a sensitivity of 60% and a specificity of 87% for AF onset prediction were observed. The cTnI serum levels at the postoperative period after CABG were higher in patients who subsequently developed AF. The cut-off value of 0.901 ng/ml is useful for prediction and preventive therapeutic actions.

show abstract

“…All patients received blood cardioplegia enriched with glutamate and aspartate as described previously by our group [7].…”

Section: Perioperative Managementmentioning

confidence: 99%

Perioperative serum troponin I levels are associated with higher risk for atrial fibrillation in patients undergoing coronary artery bypass graft surgery

Leal

Petrucci

Godoy

et al. 2011

Interactive CardioVascular and Thoracic Surgery

View full text Add to dashboard Cite

show abstract

“…The myocardial protection that we employed in the control group of our study, the infusion of continuous retrograde microplegia, 16 is one of the accepted alternatives of a blood-based solution for comparative studies when analyzing myocardial protection, 1 and there are several clinical studies endorsing its use. 8,[17][18][19][20] Moreover, it is considered as the myocardial protection strategy that adds less volume, and therefore, minimizes the risk of hemodilution during an on-pump procedure. 8 In recent years, using both Custodiol® 1,[21][22][23] or Del Nido 1,24 cardioplegia have provided excellent results, and their use has increased worldwide.…”

Section: Discussionmentioning

confidence: 99%

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

López-Menéndez

Hycka

Morales

et al. 2018

Therapeutic Advances in Cardiovascular Disease

View full text Add to dashboard Cite

show abstract

“…1 Recently, blood-based cardioplegic solutions have gained more popularity among cardiac surgeons as several experimental and clinical studies have suggested a more favorable recovery of the myocardium after ischemia with hyperkalemic blood cardioplegia compared with the crystalloid solutions. [2][3][4][5][6] Its advocators claim the fact that blood is known to be a more physiological composition, with natural buffers and oxygen-carrying capacity, therefore providing better myocardial protection via preserving intracellular high-energy phosphates and intracellular pH and limiting calcium ion influx after ischemia. 7 Blood cardioplegia is usually prepared by mixing blood with crystalloid solutions in different rations like 3:1 or 4:1.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Bretschneider HTK and Blood Cardioplegia (4:1): A Prospective Randomized Study

Dericioğlu

Mıdı

et al. 2023

Thorac Cardiovasc Surg

View full text Add to dashboard Cite

Background We compared the effect of intermittent blood and histidine-tryptophan-ketoglutarate (HTK) solution of Bretschneider on myocardial histopathology and perioperative outcome. Methods Forty adult cardiac surgery patients were grouped into two (n = 20 for each): (1) Intermittent blood cardioplegia (IBC): had repeated cold 4:1 blood cardioplegia and (2) HTK: had a single dose of cold HTK for cardioprotection. Creatine kinase (CK)-MB, Troponin-I (cTn-I), pH, and lactate were studied in coronary sinus blood before and after aortic cross-clamping (AXC) and systemic blood at postoperative 6th, 24th, and 48th hours. Myocardial biopsy was performed before and after AXC for light microscopy. Vacuolation, inflammation, edema, and glycogen were graded semiquantitatively (from 0 to 3). The myocardial apoptotic index was evaluated via the terminal deoxynucleotidyl transferase dUTP nick end labeling. Results There were no differences in perioperative clinical outcomes between the groups. The coronary sinus samples after AXC were more acidotic (7.15 ± 0.14 vs. 7.32 ± 0.07, p = 0.001) and revealed higher CK-MB (21.0 ± 12.81 vs. 12.60 ± 11.80, p = 0.008) in HTK compared with IBC. The HTK had significantly a higher amount of erythrocyte suspension intraoperatively compared with IBC (0.21 ± 0.53 vs. 1.68 ± 0.93 U, p = 0.001). Microscopically, myocardial edema was more pronounced in HTK compared with IBC after AXC (2.25 ± 0.91 vs. 1.50 ± 0.04, p = 0.013). While a significant increase in the apoptotic index was seen after AXC in both groups (p = 0.001), no difference was detected between the groups (p = 0.417). Conclusion IBC and HTK have a similar clinical outcome and protective effect, except for more pronounced myocardial edema and increased need for intraoperative transfusion with HTK.

show abstract

Use of (All-Blood) Miniplegia Versus Crystalloid Cardioplegia in an Experimental Model of Acute Myocardial Ischemia

Abstract: The use of all-blood miniplegia provided superior protection when compared to global ischemia or crystalloid cardioplegia in acutely ischemic hearts. The model employed is very close to the clinical situation due to the use of blood as a perfusate.

Cited by 7 publications

References 21 publications

Perioperative serum troponin I levels are associated with higher risk for atrial fibrillation in patients undergoing coronary artery bypass graft surgery

Perioperative serum troponin I levels are associated with higher risk for atrial fibrillation in patients undergoing coronary artery bypass graft surgery

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

Comparison of Bretschneider HTK and Blood Cardioplegia (4:1): A Prospective Randomized Study

Contact Info

Product

Resources

About

Use of (All-Blood) Miniplegia Versus Crystalloid Cardioplegia in an Experimental Model of Acute Myocardial Ischemia

Abstract: The use of all-blood miniplegia provided superior protection when compared to global ischemia or crystalloid cardioplegia in acutely ischemic hearts. The model employed is very close to the clinical situation due to the use of blood as a perfusate.

Cited by 7 publications

References 21 publications

Perioperative serum troponin I levels are associated with higher risk for atrial fibrillation in patients undergoing coronary artery bypass graft surgery

Perioperative serum troponin I levels are associated with higher risk for atrial fibrillation in patients undergoing coronary artery bypass graft surgery

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

Comparison of Bretschneider HTK and Blood Cardioplegia (4:1): A Prospective Randomized Study

Contact Info

Product

Resources

About

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