Comparative Study Between Custodiol® versus Cold Blood Cardioplegia for Myocardial Protection in Double Valve  Replacement Surgery

Moataz Rezk Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, El-Kaluobyia, Egypt
Ashraf Wahdan Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, El-Kaluobyia, Egypt
Mahmoud Mubarak Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, El-Kaluobyia, Egypt
Mamdouh Mohamed Department of Anaesthesia Surgery, Faculty of Medicine, Banha University, Banha, El-Kaluobyia, Egypt
Mohammed Elgazzar Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, El-Kaluobyia, Egypt

DOI: https://doi.org/10.35810/ects.v3i4.193

Keywords: Double valve replacement, Cold Blood Cardioplegia, Custodiol®

Background: Several cardioplegic solutions are available for myocardial preservation. The superiority of intracellular over extracellular cardioplegia is still debated. Our study aimed to compare the results of Custodiol^® and blood Cardioplegia for myocardial protection in double valve replacement surgery.

Methods: This is a prospective study that included 301 patients. We grouped the patient into; Group A (n= 135) had Custodiol® cardioplegia, and Group B (n= 166) had cold blood cardioplegia. We included patients who had double valve surgery and excluded redo, emergency procedures, and patients who had concomitant coronary artery bypass grafting.

Results: Patients in Group A were significantly younger (43 ±9 vs. 47 ±10, P<0.001). There were 72 females (53.3%) in Group A and 71 (43.4%) in Group B (P= 0.09). The total bypass time was higher in group B (217± 40 vs. 179± 35 min, P< 0.001). The cross-clamp time was comparable between groups (90± 31 vs. 85± 29 min, P= 0.15). The duration of mechanical ventilation (7 ± 1 vs. 12 ± 2 h, P< 0.001), ICU stay (3± 0.7 vs. 4± 0.9, P< 0.001) and hospital stay (8± 1 vs. 13± 3, P< 0.001) were shorter in Group A. Postoperative wound seroma (5 (26.6%) vs. 60 (36.1%), P< 0.001) and mortality (2 (1.5%) vs. 11 (6.6%), p= 0.042) were lower in Group A.
Conclusion: Custodiol cardioplegia could be safe during double valve surgery. A larger randomized trial is required to confirm our findings.