[Protection of the myocardium during prolonged surgery of the heart valves]

Area of Science:

• Cardiovascular Surgery
• Cardiac Anesthesia
• Cardioplegia Solutions

Background:

• Valve prosthetics often require aortic clamping, necessitating myocardial protection.
• Both blood and crystalloid cardioplegia are used to preserve heart function during surgery.
• Prolonged aortic clamping presents challenges for myocardial preservation.

Purpose of the Study:

• To compare the effectiveness of blood versus crystalloid cardioplegia.
• To evaluate outcomes in valve replacement with prolonged aortic clamping.
• To identify optimal cardioplegia strategies for patients with compromised cardiac reserve.

Main Methods:

• Comparative analysis of patient outcomes.
• Assessment of myocardial protection strategies.
• Focus on valve replacement procedures with extended aortic cross-clamp times.

Main Results:

• Blood cardioplegia demonstrated superior effectiveness compared to crystalloid.
• The benefits of blood cardioplegia were more pronounced in patients with low functional myocardial reserve.
• No significant difference in overall effectiveness was noted in patients with preserved cardiac function.

Conclusions:

• Blood cardioplegia is the preferred method for myocardial protection during valve prosthetics with prolonged aortic clamping.
• Clinicians should consider patient's myocardial reserve when selecting cardioplegia type.
• Further research may explore specific blood cardioplegia compositions for enhanced outcomes.