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Chirurgia 2018 December;31(6):225-30

DOI: 10.23736/S0394-9508.18.04781-2

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Is the custodiol effective as blood cardioplegia for myocardial protection in adult cardiac surgery?

Ihab M. MOURSI , Karim M. AL FAKHARANY

Department of Cardiothoracic Surgery, Zagazig University Hospital, Zagazig, Egypt


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BACKGROUND: Long preservation time of myocardial protection offered by single dose of custodiol is an attractive option. There is little available study confirm its efficacy in comparison to conventional methods of cardioplegia. Its single administration helps to do the operation without interruption in comparison to other types of cardioplegic solutions that should be given every 20-30 minutes. We aim to study the effect of custodiol on myocardial protection in adult cardiac surgery in comparison to standard Plegisol blood cardioplegia.
METHODS: This is a retrospective single-center study of prospectively collected data at our department. Adult cardiac surgery patients operated between January 2011 and August 2013 using Custodiol solution were compared to patients using standard Plegisol blood cardioplegia. We compare the intra-operative and post-operative endpoints including 30-day mortality, renal dysfunction, and prolonged mechanical ventilation time and hospital readmission.
RESULTS: A hundred patients were studied, 60 patients used Blood Cardioplegia and 40 patients used Custodiol. Demographic data were similar in both groups with a mean patient age of 60±14.1 years for Custodiol and 66±10 years for blood cardioplegia. The cardiopulmonary bypass time average for Custodiol was 122±60 and blood cardioplegia was 135±54 minutes. The Custodiol group had a greater incidence of prolonged ventilation (>24 hours) than another group, 20% versus 15 % respectively, and it has statistical significance with a P value of (0.05). The Custodiol group shows significant intra-operative blood usage in comparison to the blood cardioplegia group. 45% of Custodiol group patients received fresh frozen plasma during the operation compared to only 25% in the blood cardioplegia group (P=0.005). There is no significant difference in other endpoints.
CONCLUSIONS: Despite the long-term ischemic tolerance advantage of custodiol and its effective role in myocardial protection. There is marked an increase in fresh frozen plasma need during the perioperative period more than that recorded with blood cardioplegia for the preservation of myocardium in adult heart surgery.


KEY WORDS: Myocardium - Custodiol-N solution - Heart arrest, induced

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