Issue |
J Extra Corpor Technol
Volume 54, Number 2, June 2022
|
|
---|---|---|
Page(s) | 135 - 141 | |
DOI | https://doi.org/10.1051/ject/202254135 | |
Published online | 15 June 2022 |
Original Articles
Impact of the Cardioplegia Interval on Myocardial Protection Using the Modified St. Thomas Solution in Minimally Invasive Mitral Valve Surgery: A Double-Center Study
* Department of Clinical Engineering, Toranomon Hospital, Tokyo, Japan;
† Showa University Postgraduate School of Health Sciences, Tokyo, Japan;
‡ Department of Cardiovascular Surgery, Toranomon Hospital, Tokyo, Japan; and
§ Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan
Address correspondence to: Kohei Nagashima, PhD, Department of Clinical Engineering, Toranomon Hospital, 2-2-2-Toranomon, Minato-ku, Tokyo 105-8470, Japan. E-mail: kouheinagashima0914@yahoo.co.jp
Received:
4
January
2022
Accepted:
23
May
2022
It has been reported that a single-dose cardioplegia interval is useful, but the safe interval doses are not clear. We aimed to investigate the impact of the cardioplegia interval on myocardial protection using the modified St. Thomas solution. We included consecutive isolated minimally invasive mitral valvuloplasty procedures (n = 229) performed at a hospital and medical center from January 2014 to December 2020. We compared postoperative peak creatine kinase MB and creatine kinase levels and other indicators between the short (Group S, n = 135; maximum myocardial protection interval <60 minutes) and long (Group L, n = 94; maximum myocardial protection interval ≥60 minutes) interval groups. Propensity score matching was used to adjust for confounders between the two groups. After propensity score matching, Groups S and L contained 47 patients each. Groups S and L did not differ significantly in peak creatine kinase MB (45.8 ± 26.3 IU/L and 41.5 ± 27.9 IU/L, respectively; p = .441) and creatine kinase levels (1,133 ± 567 IU/L and 1,100 ± 916 IU/L, respectively; p = .837) after admission to the intensive care unit on the day of surgery based on propensity score matching. In multivariate analysis, a cardioplegia dosing interval ≥60 minutes was not significantly associated with the maximum creatine kinase MB level after admission to the intensive care unit on the day of surgery (p = .354; 95% confidence interval: −1.67 to 4.65). Using the antegrade modified St. Thomas solution, the long interval dose method is useful and safe in minimally invasive mitral valvuloplasty.
Key words: cardioplegia / cardiopulmonary bypass / mitral valve surgery / myocardial protection / modified St. Thomas solution.
© 2022 AMSECT
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