The effects of St. Thomas I and St. Thomas II Cardioplegia solutions on coronary sinus lactate in mitral valve surgery; A Randomized, Double-blinded, Clinical Trial

Publish Year: 1402
نوع سند: مقاله ژورنالی
زبان: English
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JR_RIJO-11-3_002

تاریخ نمایه سازی: 19 شهریور 1402

Abstract:

Background: Cardiac protection strategies in different methods are challenging and crucial, affecting postoperative morbidity and mortality.Objectives: We compared the cardio-protective effect of two cardioplegia solutions based on coronary sinus lactate levels.Methods:  This randomized, double-blinded clinical trial study was performed on ۴۶ candidates for mitral valve replacement between June ۲۰۲۰ and January ۲۰۲۱. The patients were categorized via block randomization method: ۱) St. Thomas I cardioplegia (n=۲۳) and St. Thomas Ⅱ cardioplegia (n=۲۳). The coronary sinus lactate levels at different times were measured. In addition, some intra-operative and clinical characteristics after cardiac surgery were recorded. Data were analyzed in SPSS software (version ۲۶.۰) using paired and independent t-tests, repeated measure ANOVA, and Pearson correlation test at a significance level of P < ۰.۰۵.Results: In the time trend, the lactate levels in patients with St. Thomas Ⅱ cardioplegia solution had a significantly lower rate than in St. Thomas I (P=۰.۰۰۱). The two groups displayed no statistical difference between the aortic cross-clamp time (P=۰.۰۶۹) and the CPB time (P=۰.۰۹۱). Furthermore, the weaning from mechanical ventilation (P=۰.۰۷۸) and ICU stay (P=۰.۰۶۱) demonstrated no statistical difference between the study groups.Conclusion: Based on significantly lower measures of the coronary sinus lactate, the St. Thomas Ⅱ cardioplegia solution showed a better cardio-protective effect in patients undergoing mitral valve surgery.

Keywords:

Cardio-pulmonary Bypass , Coronary Sinus , Mitral Valve , St. Thomas' Hospital cardioplegic solution

Authors

Maryam Arki

M.Sc in Perfusion Technology, Department of Extra-Corporeal Circulation (ECC), Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

Ali Asghar Moeinipour

Associated Professor, Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

Mehdi Fathi

Associated Professor, Department of Anesthesiology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

Mohammad Abbasi Teshnizi

Professor, Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

Hossein Pasandi

M.Sc in Physiology, Department of Extra-Corporeal Circulation (ECC), Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

Majid Heydari

M.Sc in Medical-Surgical Nursing, Department of Extra-Corporeal Circulation (ECC), Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

Akram Kiani Nejad

B.Sc in Nursing, Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

Saeideh Imani Moghaddam

B.Sc in Nursing, Department of Critical Care, Razavi Hospital, Mashhad, Iran

Mohsen Yaghubi

M.Sc in Perfusion Technology, Department of Extra-Corporeal Circulation (ECC), Razavi Hospital, Mashhad, Iran