Krzysztof Sanetra1,2, Wojciech Domaradzki3, Marek Cisowski4, Krzysztof Białek3, Rajesh Shrestha3, Andrzej Bochenek3,5,6, Justyna Jankowska-Sanetra7, Piotr P Buszman8,6,7, Witold Gerber3. 1. Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Kakow University, Krakow, Poland - krzyssan@poczta.onet.pl. 2. Department of Cardiac Surgery, American Heart of Poland, Bielsko-Biała, Poland - krzyssan@poczta.onet.pl. 3. Department of Cardiac Surgery, American Heart of Poland, Bielsko-Biała, Poland. 4. Department of Cardiac Surgery, Clinical University Hospital, Opole, Poland. 5. Faculty of Medicine, University of Technology, Katowice, Poland. 6. Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland. 7. Department of Cardiology, American Heart of Poland, Bielsko-Biała, Poland. 8. Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Kakow University, Krakow, Poland.
Abstract
BACKGROUND: The evidence regarding the impact of patient's age and gender on del Nido cardioplegia cadioprotection capability in adults is strongly limited. METHODS: A group of 75 patients undergoing aortic valve replacement (AVR) with del Nido cardioplegia was divided into Group 1 (male) and Group 2 (female). Creatine kinase (CK-MB isoenzyme) and high sensitivity troponin T (hs-TnT) values at 24 hours and 48 hours, occurrence of cardiac activity during crossclamp and ventricular fibrillation (VF) during reperfusion were compared. The impact of age on hs-TnT,CK-MB, VF during reperfusion and cardiac activity during crossclamp was investigated using regression models. RESULTS: No difference between the groups was reported in 24-hour CK-MB (median 15.57 ng/ml; IQR 12.13-22.82 ng/mL vs 13.97; 12.09-17.147 ng/mL; p= .168), 48-hour CK-MB (6.19; 4.22-7.71 ng/mL vs 6.07;4.56-7.06 ng/mL; p= .707), 24-hour hs-TnT (259.2; 172.0-376.9 pg/mL vs 193.0; 167.8-351 pg/mL.1; p= .339), 48-hour hs-TnT (169.1; 124.9-293.0 pg/mL vs 159.2; 123.12-211.77 pg/mL; p= .673), VF during reperfusion (25% vs 18,5%; p= .774) and cardiac activity during arrest (39.6% vs 37.1%; p= 1.0). Values of CK-MB at 24 hours, hs-TnT at 24 hours and hs-TnT at 48 hours were not dependent on age. The CK-MB at 48 hours was dependent on age (p=.039). Probit regression failed to reveal the impact of patients' age on post-clamp VF occurrence ( p=.11) or electrical activity during arrest (p=.57) . CONCLUSIONS: Basing on study results, it can be hypothesised that the del Nido cardioplegia provides adequate myocardial protection in AVR patients regardless of age and gender.
BACKGROUND: The evidence regarding the impact of patient's age and gender on del Nido cardioplegia cadioprotection capability in adults is strongly limited. METHODS: A group of 75 patients undergoing aortic valve replacement (AVR) with del Nido cardioplegia was divided into Group 1 (male) and Group 2 (female). Creatine kinase (CK-MB isoenzyme) and high sensitivity troponin T (hs-TnT) values at 24 hours and 48 hours, occurrence of cardiac activity during crossclamp and ventricular fibrillation (VF) during reperfusion were compared. The impact of age on hs-TnT,CK-MB, VF during reperfusion and cardiac activity during crossclamp was investigated using regression models. RESULTS: No difference between the groups was reported in 24-hour CK-MB (median 15.57 ng/ml; IQR 12.13-22.82 ng/mL vs 13.97; 12.09-17.147 ng/mL; p= .168), 48-hour CK-MB (6.19; 4.22-7.71 ng/mL vs 6.07;4.56-7.06 ng/mL; p= .707), 24-hour hs-TnT (259.2; 172.0-376.9 pg/mL vs 193.0; 167.8-351 pg/mL.1; p= .339), 48-hour hs-TnT (169.1; 124.9-293.0 pg/mL vs 159.2; 123.12-211.77 pg/mL; p= .673), VF during reperfusion (25% vs 18,5%; p= .774) and cardiac activity during arrest (39.6% vs 37.1%; p= 1.0). Values of CK-MB at 24 hours, hs-TnT at 24 hours and hs-TnT at 48 hours were not dependent on age. The CK-MB at 48 hours was dependent on age (p=.039). Probit regression failed to reveal the impact of patients' age on post-clamp VF occurrence ( p=.11) or electrical activity during arrest (p=.57) . CONCLUSIONS: Basing on study results, it can be hypothesised that the del Nido cardioplegia provides adequate myocardial protection in AVR patients regardless of age and gender.
Authors: Emily Honzel; Samantha Nemeth; Brigitte E Kazzi; Alexander P Kossar; Jocelyn Sun; Yuji Kaku; Koji Takeda; Hiroo Takayama; Michael Argenziano; Jessica Spellman; Andrea Miltiades; Kenmond Fung; James Beck; Craig R Smith; Paul Kurlansky; Isaac George Journal: Eur J Cardiothorac Surg Date: 2022-10-04 Impact factor: 4.534