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Myocardial cooling with ice-slush provides no cardioprotective effects in aortic valve replacement

Bjørn Braathen1, Oystein A Vengen, Theis Tønnessen

  • 1Department of Cardiothoracic Surgery, Ullevål University Hospital, Oslo, Norway.

Scandinavian Cardiovascular Journal : SCJ
|November 23, 2006
PubMed

Insights

Topical ice-slush cooling did not offer additional heart protection during aortic valve replacement (AVR). A rigid protocol for crystalloid cardioplegia may reduce myocardial damage, as seen in historical data.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Cardioprotection

Background:

  • Topical heart cooling with ice-slush is a common method for myocardial protection.
  • The efficacy of ice-slush in reducing myocardial damage markers during aortic valve replacement (AVR) has not been prospectively evaluated.
  • A secondary aim was to assess if study participation itself influenced myocardial damage.

Purpose of the Study:

  • To prospectively evaluate the effect of topical ice-slush cooling on myocardial damage markers (CK-MB, troponin-T) during AVR.
  • To determine if the study process itself impacted myocardial damage.

Main Methods:

  • A prospective, randomized study involving 60 patients undergoing AVR.
  • Patients received cold crystalloid antegrade cardioplegia.
  • Thirty patients were randomized to receive additional topical ice-slush cooling.
  • Myocardial markers (CK-MB, troponin-T) were compared between groups and with a historical cohort.

Main Results:

  • No significant difference in myocardial damage markers was observed between patients who received ice-slush and those who did not.
  • Patients undergoing AVR prior to the study initiation exhibited significantly higher levels of troponin-T and CK-MB.
  • This suggests that the established protocol for crystalloid cardioplegia may be effective.

Conclusions:

  • Topical ice-slush cooling does not provide additional cardioprotective benefits during AVR.
  • Adherence to a strict protocol for crystalloid cardioplegia may be more critical for reducing myocardial damage.
  • The study highlights the importance of standardized protocols in cardiac surgery.
Abstract

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