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主动脉瓣置换术中单次剂量 Del Nido 心脏停搏液与血停搏液的比较。

Single-Dose Del Nido Cardioplegia vs. Blood Cardioplegia in Aortic Valve Replacement Surgery.

机构信息

Department of Cardiovascular Surgery, Adana City Training and Research Hospital, Adana, Turkey.

Department of Anesthesiology and Reanimation, Adana City Training and Research Hospital, Adana, Turkey.

出版信息

Braz J Cardiovasc Surg. 2021 Apr 1;36(2):229-236. doi: 10.21470/1678-9741-2020-0063.

Abstract

INTRODUCTION

In this study, we aimed to compare Del Nido cardioplegia (DNC) with blood cardioplegia (BC) in aortic valve replacement.

METHODS

A two-year single-institute retrospective cohort study was accomplished. Subjects who underwent aortic valve replacement surgery were divided into two groups (DNC and BC) and outcomes were compared.

RESULTS

Preoperative demographics and clinical data of the patients in both groups were similar. The time until cardiac arrest following administration of the first dose of cardioplegia was statistically significantly shorter in the BC group (47.0 sec. 25-103) than in the DNC group (63.0 sec. 48-140) (P=0.012). Cross-clamping time was longer in the BC group (48.7±12.3 min. vs. 41.5±11.8 min.) (P=0.041). Cardiopulmonary bypass time was statistically significantly shorter in the DNC group (BC 60.8±18.5 min., DNC 53.7±15.2 min.) (P=0.046). The rate of postoperative use of intravenous positive inotropic support drugs (dopamine, dobutamine, norepinephrine, etc.) for more than two hours was significantly higher in the BC group (20 [23.5%] in the BC group and nine [17.3%] in the DNC group) (P=0.035). Creatine kinase myocardial band and troponin I levels were slightly lower in patients receiving DNC, but no statistically significant difference was detected.

CONCLUSION

Del Nido cardioplegia is safe and can be used efficiently as an alternative to blood cardioplegia in isolated aortic valve replacement surgery.

摘要

简介

本研究旨在比较主动脉瓣置换术中的 Del Nido 心脏停搏液(DNC)与含血心脏停搏液(BC)。

方法

完成了一项为期两年的单中心回顾性队列研究。将接受主动脉瓣置换术的患者分为两组(DNC 和 BC)并比较结果。

结果

两组患者的术前人口统计学和临床数据相似。BC 组给予首剂心脏停搏液后心脏停搏的时间明显短于 DNC 组(47.0 秒[25-103]比 63.0 秒[48-140])(P=0.012)。BC 组的体外循环时间(48.7±12.3 分钟)比 DNC 组长(41.5±11.8 分钟)(P=0.041)。DNC 组的体外循环时间明显短于 BC 组(BC 60.8±18.5 分钟,DNC 53.7±15.2 分钟)(P=0.046)。BC 组术后静脉应用正性肌力支持药物(多巴胺、多巴酚丁胺、去甲肾上腺素等)2 小时以上的比例明显高于 DNC 组(BC 组 20[23.5%], DNC 组 9[17.3%])(P=0.035)。DNC 组的肌酸激酶肌球蛋白和肌钙蛋白 I 水平略低,但未检测到统计学差异。

结论

Del Nido 心脏停搏液安全有效,可作为单纯主动脉瓣置换术的含血心脏停搏液的替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/babd/8163264/b5637756e52a/rbccv-36-02-0229-g01.jpg

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