Comparison of Bretschneider HTK cardioplegia solution and blood cardioplegia in terms of postoperative results in patients who underwent isolated supracoronary ascending aortic replacement

• Published in: Perfusion 2024-09, Vol.39 (6), p.1205-1212
• Main Authors: Tunca, Nuri Utkan, Yesilkaya, Nihan Karakas, Karaagac, Erturk, Durmaz, Huseyin, Besir, Yuksel, Gokalp, Orhan, Iner, Hasan, Yılık, Levent, Gurbuz, Ali
• Format: Article
• Language: English
• Subjects: Aged; Aorta; Aorta - surgery; Aortic dissection; Aortic Dissection - surgery; Arrhythmia; Blood; Bypass; Cardioplegic Solutions - pharmacology; Cardioplegic Solutions - therapeutic use; Dissection; Female; Glucose - pharmacology; Glucose - therapeutic use; Heart; Heart Arrest, Induced - methods; Heart surgery; Histidine; Hospitals; Humans; Intensive care; Male; Mannitol - pharmacology; Mannitol - therapeutic use; Mechanical ventilation; Middle Aged; Neurological complications; Patients; Potassium Chloride - pharmacology; Potassium Chloride - therapeutic use; Procaine - pharmacology; Procaine - therapeutic use; Tryptophan; Weaning
• ISSN: 0267-6591; 1477-111X; 1477-111X
• DOI: 10.1177/02676591231182587

Introduction Cardiac arrest with cardioplegia is the most common and reliable method of myocardial protection in cardiac surgery, but there is no definite consensus on the use of different types of cardioplegia. Two of the commonly used types of cardioplegia are Bretschneider histidine-tryptophan-ketoglutarate solution (Custodiol) and conventional blood cardioplegia. In this study, Custodiol solution and conventional blood cardioplegia used in patients with type A aortic dissection who underwent supracoronary ascending aortic replacement were aimed to be compared in terms of postoperative results. Methods 70 patients with type A aortic dissection who underwent supracoronary ascending aortic replacement in our clinic between January 2011 – October 2020 were included. Patients were divided into two groups, blood cardioplegia group (n = 48) and Custodiol group (n = 22) and they were compared regarding preoperative, perioperative and postoperative variables. Results There was no significant difference between cardiopulmonary bypass time and cross-clamp time (p = 0.17 and p = 0.16, respectively). Mechanical ventilator weaning time, intensive care unit stay and hospital stay were shorter in Custodiol group (p = 0.04,p = 0.03 and p = 0.05, respectively). While inotropic support need was higher in the blood cardioplegia group (p = 0.001), there was no significant difference in terms of mortality, arrhythmia, neurological complications and renal complications. Conclusions Our results show that Custodiol cardioplegia solution may be superior to blood cardioplegia in reducing mechanical ventilation weaning period, intensive care and hospital stay, and reducing the use of inotropic agents in patients with type A aortic dissection undergoing supracoronary ascending aorta replacement.