Minimally Invasive Mitral Valve Surgery using Single Dose Antegrade Custodiol Cardioplegia - 18/09/14
, Michelle J. Murphy, BAMod(Hons) a, William M. Weightman, MB, ChB a, Neville M. Gibbs, MBBS, MD a, J. James B. Edelman, MBBS(Hons), PhD b, Jurgen Passage, FRACS b, cRiassunto |
Objective |
Our unit began a minimally invasive mitral surgery (MIMS) program utilising antegrade Custodiol solution as the sole cardioplegia. The aim of this paper is to report our results of this program.
Patients/Methods |
Early clinical outcomes were identified and assessed for the first consecutive 100 MIMS patients with comparisons made to a historical group operated via a sternotomy (n=113). The efficacy of myocardial protection was assessed using surrogate outcomes of myocardial protection with serial sodium concentrations also analysed.
Results |
Six hours postoperatively 12 patients required inotropic support. Peak troponin-I in the first 24hours was 5.1 (0.8-40μg/L [median(range)]. Sodium levels decreased following administration of Custodiol but by six hours postoperatively the sodium had returned to greater than 130mmol/L in all but five patients. Blood transfusion was smaller in the MIMS versus historical group (RBC 17% vs. 65%). MIMS patients had a shorter duration of ventilation, hospital stay and one-year mortality rate (0%).
Conclusions |
In this series of patients undergoing MIMS, single dose antegrade Custodiol offers satisfactory and safe myocardial protection. Early clinical outcomes were also satisfactory. Whilst our findings are observational, they nevertheless support the use of this less invasive approach to mitral surgery using single dose Custodiol for myocardial protection.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Myocardial protection/cardioplegia, Minimally invasive surgery, Mitral valve repair, Mitral valve replacement, Cardiopulmonary bypass, CPB
Mappa
Vol 23 - N° 9
P. 863-868 - settembre 2014 Ritorno al numero
Articolo precedente
- Organ Dysfunction in Patients with Left Ventricular Impairment: What is the Effect of Cardiopulmonary Bypass?
- Omar A. Jarral, Srdjan Saso, Leanne Harling, Hutan Ashrafian, Hatam Naase, Roberto Casula, Thanos Athanasiou
- Risk Factors for Prolonged Mechanical Ventilation After Total Aortic Arch Replacement for Acute DeBakey Type I Aortic Dissection
- Cheng-Nan Li, Lei Chen, Yi-Peng Ge, Jun-Ming Zhu, Yong-Min Liu, Jun Zheng, Wei Liu, Wei-Guo Ma, Li-Zhong Sun
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.
Già abbonato a @@106933@@ rivista ?