Custodiol versus Blood Cardioplegia: Comparison of Myocardial Immunohistochemical Analysis and Clinical Outcomes

Area of Science:

• Cardiology
• Cardiac Surgery
• Biochemistry

Background:

• Custodiol (histidine-tryptophan-ketoglutarate) and repetitive blood cardioplegia are standard methods for myocardial protection during cardiac arrest.
• Comparing their efficacy is crucial for optimizing surgical outcomes.

Purpose of the Study:

• To compare Custodiol and blood cardioplegia regarding immunohistochemical analysis, clinical outcomes, and cardiac enzyme values.
• To evaluate the effectiveness of these cardioplegic solutions in cardiac surgery.

Main Methods:

• A randomized prospective study involving 20 patients undergoing mitral and/or tricuspid valve surgery.
• Patients were divided into two groups: Custodiol cardioplegia (Group 1) and blood cardioplegia (Group 2).
• Data collected included perioperative/postoperative cardiac events, serial cardiac enzyme analysis, and myocardial immunohistochemical analysis.

Main Results:

• No significant differences were observed in perioperative and postoperative cardiac performance or adverse events between the Custodiol and blood cardioplegia groups.
• Cardiac enzyme analysis revealed no significant differences between the two groups.
• Immunohistochemical studies indicated that Custodiol was superior in terms of eNOS and Bcl-2 expression, suggesting better cellular oxidative stress resistance and viability.

Conclusions:

• Both Custodiol and blood cardioplegia provide similar clinical outcomes and myocardial protection based on cardiac enzyme levels.
• Custodiol exhibits enhanced cellular protection, as evidenced by superior immunohistochemical markers related to oxidative stress resistance and cell viability.