Background: This study was performed to investigate the effect of temperature of blood cardioplegia on the recovery of postischemic cardiac function.
Methods: Pigs on cardiopulmonary bypass were subjected to global ischemia (30 minutes), followed by cold (n = 10) or warm (n = 11) continuous antegrade blood cardioplegia (45 minutes) delivered at 55-60 mm Hg.
Results: Global left ventricular function, evaluated by preload recruitable stroke work, decreased with cold cardioplegia from 91 (85-103) [mean (quartile interval)], at baseline, to 73 (55-87) erg x 10(3)/mL postbypass (p = 0.03), but was unchanged after warm cardioplegia; 110 (80-132) to 109 (71-175) erg x 10(3)/mL (p > 0.5). However, the difference between treatment effects was not significant (p = 0.25). Diastolic function, evaluated by end-diastolic pressure-volume relation, deteriorated without any difference between groups. Mean cardioplegic flow was similar between groups. Coronary vascular resistance increased at constant rate during warm cardioplegic delivery, but remained unchanged with cold cardioplegia (p = 0.001 between regression coefficients).
Conclusions: No significant difference was found in postischemic functional recovery comparing cold and warm continuous blood cardioplegia. Cold cardioplegia is therefore preferred due to added safety of hypothermia.
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http://dx.doi.org/10.1016/s0003-4975(99)00759-6 | DOI Listing |
J Cardiothorac Surg
January 2025
Department of Surgery, Division of Cardiac Surgery, Jefferson-Einstein Medical Center Philadelphia, Philadelphia, PA, USA.
Background: End-Stage Renal Disease (ESRD) is an independent risk factor in outcomes for traditional coronary artery bypass grafting (TRAD-CAB) utilizing aortic cross-clamping and cardioplegic arrest. In order to determine if Beating-Heart CABG (BH-CABG) techniques offer benefit in patients with ESRD, an analysis of the Society of Thoracic Surgeons (STS) predicted risk versus the actual outcomes was performed.
Methods: Between March 2017 - October 2023, all ESRD patients underwent BH-CABG by a single surgeon at a single institution.
Biomedicines
December 2024
Ludwig Boltzmann Institute for Cardiovascular Research, Center for Biomedical Research and Translational Surgery, Medical University of Vienna, 1090 Vienna, Austria.
Previously, we showed that blood-based polarizing cardioplegia exerted beneficial cardioprotection during hypothermic ischemia; however, these positive effects of blood-based polarizing cardioplegia were reduced during normothermic ischemia compared to blood-based hyperkalemic (depolarizing) cardioplegia. This study compares crystalloid polarizing cardioplegia to crystalloid depolarizing cardioplegia in a normothermic porcine model of cardiopulmonary bypass; Methods: Twelve pigs were randomized to receive either normothermic polarizing ( = 7) or depolarizing ( = 5) crystalloid cardioplegia. After the initiation of cardiopulmonary bypass, normothermic arrest (34 °C, 60 min) was followed by 60 min of on-pump and 90 min of off-pump reperfusion.
View Article and Find Full Text PDFBMJ Open
December 2024
Centre for Rehabilitation and Ageing Research, University of Nottingham, Nottingham, UK.
Objective: To codesign and develop an intervention to promote participation and well-being in children and young people (CYP) with acquired brain injury (ABI) and family caregivers.
Design: A complex intervention development study including a scoping review, mixed-methods study, co-design workshop and theoretical modelling.
Setting: Community-dwelling participants in one geographical region of the UK.
Perfusion
January 2025
Department of Cardiothoracic Surgery, Lankenau Heart Institute, Wynnewood, PA, USA.
Purpose: Research on the safety and efficacy of del Nido cardioplegia in adult patients with reduced left ventricular ejection fraction (LVEF) is limited. We evaluated the effect of del Nido cardioplegia on early outcomes of cardiac surgery in this cohort.
Methods: PubMed, Scopus, and the Cochrane Central Register of Controlled Trials were searched through August 2024 to conduct a meta-analysis comparing del Nido to other cardioplegia in adult patients with reduced LVEF (≤50%).
Xenotransplantation
January 2025
Division of Cardiac Surgery, Department of Surgery, Children's Hospital of Los Angeles, Los Angeles, California, USA.
Introduction: There is no standard protocol for management of organ preservation for orthotopic, life-sustaining cardiac xenotransplantation, particularly for hearts from pediatric sized donors. Standard techniques and solutions successful in human allotransplantation are not viable. We theorized that a solution commonly used in reparative cardiac surgery in human children would suffice by exploiting the advantages inherent to xenotransplantation, namely the ability to reduce organ ischemic times by co-locating the donor and recipient.
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