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|Title: ||Continuous retrograde blood cardioplegia is associated with lower hospital mortality after heart valve surgery|
|Authors: ||Flameng, W.J.|
|Issue Date: ||2003|
|Publisher: ||MOSBY, INC|
|Citation: ||The journal of thoracic and cardiovascular surgery, 125(1). p. 121-125|
|Abstract: ||Objective: Myocardial preservation studies comparing blood and crystalloid cardioplegia techniques were almost exclusively performed on patients undergoing coronary bypass, and they were unable to show a difference in hospital mortality. We investigated possible factors, including cardioplegia techniques, influencing hospital mortality in patients undergoing cardiac valve surgery.
Methods: We evaluated hospital mortality in 1098 consecutive patients undergoing cardiac valve surgery by using a multivariate logistic regression with propensity score balancing of the groups. In 25% of the patients, multiple valve or Bentall procedures were performed, and in 46% of all patients, coronary bypass grafting was associated with valve surgery. A first cohort of 504 consecutive patients were operated on by using single-shot antegrade cold crystalloid cardioplegia, and a second cohort of 594 patients were operated on by using continuous retrograde cold blood cardioplegia.
Results: After correction for patient-related and operative risk factors, lower hospital mortality was found in patients who received retrograde blood cardioplegia (P = .020). The odds ratio of in-hospital death when using blood cardioplegia was 0.44 (95% confidence interval, 0.22-0.88). Further predictors of hospital mortality were age, advanced New York Heart Association functional class, cardiopulmonary bypass time, reoperation, active endocarditis, and renal failure.
Conclusions: This study shows that continuous retrograde blood cardioplegia is associated with lower hospital mortality in heart valve operations.|
|ISI #: ||000180579300023|
|Type: ||Journal Contribution|
|Appears in Collections: ||Research publications|
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