Clinical Study of Myocardial Protection: Comparison of Cold Blood Cardioplegia & Cold Crystalloid Cardioplegia in Mitral Valve Replacement
Keywords:
Crystalloid Cardioplegia, Blood Cardioplegia, Myocardial Protection, Cardiopulmonary Bypass, Open Heart SurgeryAbstract
This article aims to assess the clinical outcome of two groups of patients by using cold blood cardioplegia and cold crystalloid cardioplegia for myocardial protection during the mitral valve replacement in open-heart surgical cases. Clinical data were collected from hospital records of the patients who underwent open-heart surgery for mitral valve replacement. 20 patients were divided into two groups. Group A included 10 patients treated with cold crystalloid cardioplegia used. Group B included 10 patients operated on where cold blood cardioplegia was used for myocardial protection. Data was analyzed in both groups by using the T-test for continuous variables. And Chi-Square Test was performed for categorical variables. There was no significant difference in cross-clamp time, bypass time in both groups. Use of cardioversion after declamping in Group A was 10% and 10% in Group B. Use of inotropic agents when CPB stop 90% in Group A and 50% in Group B. Mean duration of mechanical ventilatory support was 12.20 hours in Group A and 11.30 hours in Group B. Mean blood drainage was 1.651 ml in Group A and 1.492 ml in Group B. Use of inotropic agents to keep the systolic blood pressure > 100 mmHg was 60% in Group A and 80% in Group B. There was no significant difference in CK and CK-MB during and after the operation but there was a significant difference in Tn1 during surgery after 30 minutes of CPB. Different cardioplegia techniques and strategies have been demonstrated to be safe and useful in cardiac surgery. Cold blood cardioplegia provides myocardial protection better than cold crystalloid cardioplegia.
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