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Observational Study
. 2023 Feb;16(1):192-198.
doi: 10.1007/s12265-022-10296-z. Epub 2022 Aug 8.

Single-Dose St. Thomas Versus Custodiol® Cardioplegia for Right Mini-thoracotomy Mitral Valve Surgery

Cristina Barbero #  1 , Marco Pocar #  2   3   4 , Giovanni Marchetto  2 , Erik Cura Stura  2 , Claudia Calia  2   3 , Bianca Dalbesio  2 , Claudia Filippini  3 , Stefano Salizzoni  2   3 , Massimo Boffini  2   3 , Mauro Rinaldi  2   3 , Davide Ricci  5
Affiliations
Observational Study

Single-Dose St. Thomas Versus Custodiol® Cardioplegia for Right Mini-thoracotomy Mitral Valve Surgery

Cristina Barbero et al. J Cardiovasc Transl Res. 2023 Feb.

Abstract

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.

Keywords: Cardiopulmonary bypass; Crystalloid cardioplegia; Minimally invasive surgery; Mitral valve repair; Myocardial protection.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
cTn-T and CK-MB activities. cTn-T: cardiac Troponin T; CK-MB: creatinine kinase-myocardial band; HTK: hystidine-triptophan-ketoglutarate
See this image and copyright information in PMC

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