Comparing the Efficacy of Custodiol and Cold Blood Cardioplegia in Myocardial Preservation

Shady Arboud; El Sayed Fayad; Mohamed Amr; Hany  Eldemiaty

Shady Arboud Department of Cardiothoracic Surgery, Nasser Institute, Cairo, Egypt
El Sayed Fayad Department of Cardiothoracic Surgery, Suez Canal University, Egypt
Mohamed Amr Department of Cardiothoracic Surgery, Suez Canal University, Egypt
Hany Eldemiaty Department of Cardiothoracic Surgery, Suez Canal University, Egypt

Keywords: Cardiac surgery, Hypothermic hyperkalaemic arrest, Myocardial preservation, Cardiology

Abstract

Background: Strategies for myocardial protection vary among surgeons, and data on the optimal cardioplegia solution are insufficient. The perfect cardioplegia solution for myocardial protection during cardiac surgery is still controversial. This study aimed to compare the efficacy of custodiol and cold blood cardioplegia in preserving the myocardium.

Methods: In this comparative prospective study, the patients were split into two groups of 60 patients each. Group A received Custodiol HTK solution, whereas Group B received cold blood cardioplegia. Preoperative laboratory investigations, operative data, postoperative ICU stays, and complications were compared between groups.

Results: The number of cardioplegia doses was significantly greater in Group B (1.05 ± 0.22, vs. 1.90 ± 0.82; p<0.001). There were no significant differences between the cardioplegia groups regarding hospital stay (p= 0.246), intensive care unit stay (p= 0.144), mortality (p= 0.769), low cardiac output (p>0.99), postoperative myocardial infarction (p= 0.432), intra-aortic balloon pump insertion (p= 0.224), reoperation (p>0.99), duration of mechanical ventilation (p= 0.389), pulmonary complications (p= 0.432), stroke (p>0.99), or the need for renal dialysis (p= 0.559).

Conclusions: Custodiol cardioplegia could be advantageous in cardiac surgeries when a longer duration is expected. However, this study did not report differences in postoperative outcomes between patients with custodiol or cold blood cardioplegia.