Impact of the Cardioplegia Interval on Myocardial Protection Using the Modified St. Thomas Solution in Minimally...

Area of Science:

• Cardiology
• Cardiac Surgery
• Cardioplegia Solutions

Background:

• The optimal duration of cardioplegia intervals for myocardial protection remains unclear.
• Single-dose cardioplegia is considered useful, but safe interval doses require further investigation.

Purpose of the Study:

• To evaluate the impact of cardioplegia interval duration on myocardial protection during minimally invasive mitral valvuloplasty.
• To assess the safety and efficacy of a longer cardioplegia interval (≥60 minutes) using the modified St. Thomas solution.

Main Methods:

• A retrospective analysis of 229 isolated minimally invasive mitral valvuloplasty procedures (January 2014 - December 2020).
• Patients were divided into short (<60 minutes) and long (≥60 minutes) cardioplegia interval groups.
• Propensity score matching was employed to control for confounding variables, resulting in 47 patients per group for analysis.

Main Results:

• Postoperative peak creatine kinase MB and creatine kinase levels did not significantly differ between the short and long interval groups after propensity score matching.
• Multivariate analysis indicated no significant association between a cardioplegia interval of ≥60 minutes and peak creatine kinase MB levels.
• The study found the long interval dose method to be useful and safe in this patient cohort.

Conclusions:

• A cardioplegia interval of 60 minutes or longer, utilizing the antegrade modified St. Thomas solution, provides adequate myocardial protection in minimally invasive mitral valvuloplasty.
• The findings support the safety and utility of extended cardioplegia intervals in this specific surgical context.