右小切口二尖瓣手术中单次剂量的 St. Thomas 与 Custodiol 心脏停搏液的比较。
Single-Dose St. Thomas Versus Custodiol® Cardioplegia for Right Mini-thoracotomy Mitral Valve Surgery.
机构信息
Cardiovascular and Thoracic Department, Division of Cardiac Surgery, , Città Della Salute E Della Scienza", University of Turin, Corso Dogliotti, 14, Turin, Italy.
Department of Surgical Sciences, University of Turin, Turin, Italy.
出版信息
J Cardiovasc Transl Res. 2023 Feb;16(1):192-198. doi: 10.1007/s12265-022-10296-z. Epub 2022 Aug 8.
OBJECTIVE
Custodiol® and St. Thomas cardioplegia are widely employed in mini-thoracotomy mitral valve (MV) operations. One-dose of the former provides 3 h of myocardial protection. Conversely, St. Thomas solution is usually reinfused every 30 min and safety of single delivery is unknown. We aimed to compare single-shot St. Thomas versus Custodiol® cardioplegia.
METHODS
Primary endpoint of the prospective observational study was cardiac troponin T level at different post-operative time-points. Propensity-weighted treatment served to adjust for confounding factors.
RESULTS
Thirty-nine patients receiving St. Thomas were compared with 25 patients receiving Custodiol® cardioplegia; cross-clamping always exceeded 45 min. No differences were found in postoperative markers of myocardial injury. Ventricular fibrillation at the resumption of electric activity was more frequent following Custodiol® cardioplegia (P = .01).
CONCLUSION
Effective myocardial protection exceeding 1 h of ischemic arrest can be achieved with a single-dose St. Thomas cardioplegia in selected patients undergoing right mini-thoracotomy MV surgery.
目的
Custodiol® 和 St. Thomas 心脏停搏液广泛应用于微创小切口二尖瓣（MV）手术中。前者一剂可提供 3 小时的心肌保护。相反，St. Thomas 溶液通常每 30 分钟再灌注一次，单次给药的安全性尚不清楚。我们旨在比较单次给药的 St. Thomas 与 Custodiol® 心脏停搏液。
方法
前瞻性观察研究的主要终点是不同术后时间点的心肌肌钙蛋白 T 水平。倾向评分治疗用于调整混杂因素。
结果
39 例接受 St. Thomas 心脏停搏液的患者与 25 例接受 Custodiol® 心脏停搏液的患者进行比较；钳夹时间均超过 45 分钟。心肌损伤的术后标志物无差异。在恢复电活动时 Custodiol® 心脏停搏液组更常发生心室颤动（P=0.01）。
结论
在接受右侧微创小切口 MV 手术的选定患者中，单次剂量的 St. Thomas 心脏停搏液可实现超过 1 小时缺血阻断的有效心肌保护。
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