Custodial Cardioplegia and Cardiac Preservation during pediatric Cardiac Surgery Procedures: A Narrative Review

J. Ramezani, Hamid Hoseinikhah, Kayhan Mizani, M. Akbari, Mahsa Moallemi, Maryam Argi, Aliasghar Moeinipour
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Abstract

Controlled intraoperative cardioplegia is indispensable to pediatric cardiac surgery procedures. Several preservation techniques have been proposed for such purposes, with varying application by different surgeons. The custodiol cardioplegia is a recent approach that is considered to be a safe and effective cardiac protector. This narrative review was conducted via searching in four databases, including PubMed, Scopus, Embase, and ScienceDirect. The studies focused on the efficacy and safety of custodiol cardioplegia reviewed, especially in pediatric cardiac surgeries and relevant procedures. In total, 21 articles were eligible, and the findings highlighted the controversies regarding the use of various cardioplegic solutions and the variability of their application by surgeons. However, data were inadequate regarding the optimal cardioplegic solutions in this regard. Some of the studies performed on adults suggested that custodiol cardioplegia may be equivalent to conventional blood cardioplegia. Most of the reviewed articles showed a consensus on the safety and efficacy of custodiol cardioplegia in adult and pediatric cardiac surgeries. It is believed that custodiol procedures are not only easily delivered, but they are also convenient and less time-consuming and provide long-lasting motion and bloodless fields for the surgeon to perform the operation. Therefore, use of custodiol cardioplegia has been reported to be safe, effective, and cost-efficient compared to conventional cardioplegic solutions. However, different findings have also been denoted in some of the studies in this regard, implying the equal effectiveness of these techniques.
小儿心脏外科手术期间的监护性心脏麻痹和心脏保存:叙述性综述
术中控制性心脏停搏液是小儿心脏外科手术中必不可少的。为了达到这种目的,已经提出了几种保存技术,不同的外科医生应用不同。库托地尔心脏停搏液是一种新的方法,被认为是一种安全有效的心脏保护剂。这篇叙述性综述是通过在PubMed、Scopus、Embase和ScienceDirect四个数据库中搜索进行的。综述了卡司定停搏液的有效性和安全性,特别是在儿科心脏手术和相关程序中的研究。总共有21篇文章符合条件,研究结果突出了关于各种停搏液的使用以及外科医生应用的可变性的争议。然而,关于这方面的最佳心脏停搏液的数据并不充分。一些对成人进行的研究表明,卡司定停搏液可能相当于传统的血液停搏液。大多数综述文章显示,在成人和儿童心脏手术中,对库托地尔心脏停搏液的安全性和有效性达成了共识。据信,custodiol手术不仅容易进行,而且方便、耗时少,为外科医生进行手术提供了持久的运动和无血区。因此,据报道,与传统的心脏停搏液相比,使用custodiol心脏停搏剂是安全、有效和成本效益高的。然而,在这方面的一些研究中也有不同的发现,这意味着这些技术的有效性相同。
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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