Comparison of Clinical Outcomes between del Nido Cardioplegia and Microplegia among Patients Undergoing Elective Mitral Valve Replacement.

IF 0.7 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Erhan Hafız, Özgür Altınbaş, Işık Betil Kutlu, Mehmet Moda, Mehmet Adnan Celkan
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引用次数: 0

Abstract

Background: Cardioplegia solutions are used to protect the myocardium from ischemic injury caused by cardiopulmonary bypass and various types of cardioplegia solutions have been introduced for cardiac surgery. In this study, we aimed to compare the effects of del Nido cardioplegia and microplegia, which were mostly used in our clinic for intraoperative and postoperative processes among patients who underwent elective mitral valve replacement. As a result, the comparison could be performed in a specific patient group without additional valvular or coronary disease, and cardioplegia distribution could be achieved more efficiently.

Methods: Between 2018 and 2023, a total of 120 patients who underwent elective mitral valve replacement via sternotomy with del Nido cardioplegia or microplegia were included in the study. Patients were divided into two groups; group 1 (del Nido, n = 64) and group 2 (microplegia, n = 56). Preoperative characteristics, intraoperative and postoperative early clinical data as primary outcomes, and postoperative mortality rates and intensive care costs as secondary outcomes were compared statistically.

Results: There were no statistically significant differences in terms of preoperative characteristics between the two groups. Duration of cross clamp differences between group 1 versus group 2 (45 ± 16 vs. 57 ± 19 min), cardiopulmonary bypass (56 ± 17 vs. 65 ± 21 min), intensive care length of stay (18.04 ± 7.41 vs. 22.37 ± 6.86 h), requirement of intraoperative defibrillation (n = 5 vs. n = 13), and intensive care costs were found to be statistically significantly lower in del Nido group.

Conclusion: Either del Nido or microplegia solutions can be used safely in mitral valve replacement operations, however, del Nido cardioplegia has some advantages over intraoperative processes, such as lowering the cross clamp and cardiopulmonary bypass time. Furthermore, patients who received del Nido cardioplegia had shorter intensive care stay and required less intraoperative defibrillation compared with the microplegia group. Therefore, less exposure to anesthesia, the prevention of infection due to shortened operation duration, and greater cost-effectiveness can be achieved by using del Nido cardioplegia instead of microplegia.

在接受二尖瓣置换术的患者中比较德尔尼多心脏麻痹和微静脉麻醉的临床效果。
背景:心脏麻痹溶液用于保护心肌免受心肺旁路术造成的缺血性损伤,目前已有各种类型的心脏麻痹溶液用于心脏手术。在这项研究中,我们的目的是比较德尔尼多心脏麻痹和微静脉麻醉的效果,这两种麻醉方法在我们的临床中主要用于择期二尖瓣置换术患者的术中和术后过程。因此,可以在没有其他瓣膜或冠状动脉疾病的特定患者群体中进行比较,并且可以更有效地实现心麻分布:在2018年至2023年期间,共有120名通过胸骨切开术行择期二尖瓣置换术的患者被纳入研究,并使用del Nido心脏麻痹或微瘫。患者分为两组:第1组(德尔尼多,64人)和第2组(微镇痛,56人)。将术前特征、术中和术后早期临床数据作为主要结果,术后死亡率和重症监护费用作为次要结果,并进行统计比较:结果:两组患者的术前特征差异无统计学意义。德尔尼多组的交叉钳夹时间(45±16 分钟对 57±19 分钟)、心肺旁路时间(56±17 分钟对 65±21 分钟)、重症监护住院时间(18.04±7.41 小时对 22.37±6.86 小时)、术中除颤需求(n = 5 对 n = 13)和重症监护费用均显著低于德尔尼多组:结论:二尖瓣置换术中可安全使用德尔尼多或微静脉麻醉溶液,但德尔尼多心脏麻痹与术中过程相比具有一些优势,如减少交叉钳夹和心肺旁路时间。此外,与微静脉注射组相比,接受德尔尼多心脏麻痹的患者重症监护时间更短,术中除颤需求更少。因此,使用德尔尼多心脏麻痹替代微静脉注射可以减少麻醉暴露,缩短手术时间以防止感染,并提高成本效益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Heart Surgery Forum
Heart Surgery Forum 医学-外科
CiteScore
1.20
自引率
16.70%
发文量
130
审稿时长
6-12 weeks
期刊介绍: The Heart Surgery Forum® is an international peer-reviewed, open access journal seeking original investigative and clinical work on any subject germane to the science or practice of modern cardiac care. The HSF publishes original scientific reports, collective reviews, case reports, editorials, and letters to the editor. New manuscripts are reviewed by reviewers for originality, content, relevancy and adherence to scientific principles in a double-blind process. The HSF features a streamlined submission and peer review process with an anticipated completion time of 30 to 60 days from the date of receipt of the original manuscript. Authors are encouraged to submit full color images and video that will be included in the web version of the journal at no charge.
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