Ventricular arrhythmia after aortic declamping during heart valve surgery: Comparison between Custodiol cardioplegia and cold blood cardioplegia
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Abstract
The purpose of this retrospective study was to investigate the incidence of ventricular arrhythmias after aortic declamping and the outcomes of custodial cardioplegia compared with blood CPG in patients undergoing single heart valve surgery, double heart valve surgery and triple heart valve surgery. Method: data were collected from the medical record database of heart valve surgery patients at Naresuan University Hospital in Phitsanulok province from 2015 - 2021. The participants were patients undergoing heart valve surgery, received custodiol cardioplegia or blood cardioplegia, aged between 20 - 70 years and selective random sampling according to the inclusion and exclusion criteria. The research instruments were a general information and a surgical information form. The results showed that the total number of heart valve surgery was 105 patients, 59 single heart valve surgery, 33 double heart valve surgery and 13 triple heart valve surgery. The rate of ventricular arrhythmias in single heart valve surgery who received custodial cardioplegia was significantly higher than those received cold blood cardioplegia (6 (25.00):1(2.90); p = 0.010). The propensity for ventricular arrhythmias was in the same direction as patients undergoing double and triple heart valve surgery. The outcome of using both cardioplegia solution in patients undergoing single, double and triple heart valve surgery including Intra-aortic balloon pump, ICU stay, and hospital length of stay was found to be no different.
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References
Otto CM, Bonow RO. Valveular heart disease. In Bonow RO, editor. Braunwald’s heart disease: a textbook of cardiovascular medicine. 9th ed. Singapore, Elsevier 2012; p.1468-539.
Suwanakitch P. Heart-lung machine: principle and practice. 2nd ed. Phitsanulok: Naresuan University Publishing House; 2019. p.77-80. (in Thai).
Chai PJ, Kussman BD. Myocardial protection for neonates and infants. In: Gravlee GP, editor. Cardiopulmonary bypass and mechanical support principles and practice. 4th ed. Philadelphia, Wolters Kluwer; 2016. p.683-95.
Chanmayka T, Mitprachapranee C, Wongbhuddha C, Prathanee S, Kuptanond C. Myocardial protection by retrograde application of Bretschneider cardioplegia during heart valve surgery. J Med Assoc Thai 2018; 101(5):185.
Silarat S, Suwongkrua T, Chanthawong S. Incidence of ventricular arrhythmia after aortic declamping during mitral valve surgery: comparison between the use of Bretschneider-HTK and cold blood cardioplegia. Srinagarind Medical Journal 2017; 32(2): 98-104. (in Thai)
Yamaguchi H, Weil M, Tang W, Kamohara T, Jin X, Bisera J. Myocardial dysfunction after electrical defibrillation. Resuscitation 2002; 54: 289-96.
American heart association. Classes of heart failure [Internet]. 2023 [cited 2023 May 15]. Available from
https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure/classes-of-heart-failure
Nashef SAM, Roques F, Sharples LD, Nilsson J, Smith C, Goldstone AR, et al. EuroSCORE II. Eur J Cardiothorac Sur 2012; 41: 734-4.
Ruangpratheep C. Cellular injury. Asian Archives of Pathology 2019; 1(1): 1-12. (in Thai)
Sindhvananda W. Magnesium in perioperative care. Chula Med J 2002; 46(3): 239-54. (in Thai)
Beecham GB, Nessel TA, Goyal A. Lidocaine. [Internet]. 2022 [cited 2023 May 15]. Available from: https://www.ncbi. nlm.nih.gov/books/NBK539881/
Gurabi Z, Koncz I, Patocskai B, Nesterenko VV, Antzelevitch C. Cellular mechanism underlying hypothermia-induced VT/VF in the setting of early repolarization and the protective effect of Quinidine, Cilostazol and Milrinone. Circ Arrhythm Electrophysiol 2014; 7(1): 134–42.
Abdelmajeed AM, Kerdany ABE, Ibrahim AA, Hameed OAA, AbdAllahSolima A. Custodiol versus extracellular crystalloid cardioplegia in mitral valve replacement in patients with low ejection fraction. The Egyptian Journal of Surgery 2021; 40: 375–9.
Barbero C, Pocar M, Marchetto G, Stura EC, Calia C, Dalbesio B, et al. Single Dose St. Thomas Versus Custodiol® Cardioplegia for Right Mini thoracotomy Mitral Valve Surgery. Journal of Cardiovascular Translational Research 2023; 16: 192–8.
Martin DP, Gomez D, Tobias JD, Schechter W, Cusi C, Cert AT, et al. Severe hyperkalemia during cardiopulmonary bypass: etiology and effective therapy. World Journal for Pediatric and Congenital Heart Surgery 2013; 4(2): 197-200.