Bretschneider (Custodiol®) and St. Thomas 2 Cardioplegia Solution in Mitral Valve Repair via Anterolateral Right Thoracotomy: A Propensity-Modelled Comparison
Background. Single-dose cardioplegia is preferred in minimal invasive mitral valve surgery to maintain the adjustment of the operative site without change of preset visualization. The aim of our study was to compare two widely used crystalloid cardioplegias Bretschneider (Custodiol®) versus St. Thom...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Mediators of Inflammation |
| Online Access: | http://dx.doi.org/10.1155/2019/5648051 |
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| author | Constantin Mork Luca Koechlin Thibault Schaeffer Lena Schoemig Urs Zenklusen Brigitta Gahl Oliver Reuthebuch Friedrich S. Eckstein Martin T. R. Grapow |
| author_facet | Constantin Mork Luca Koechlin Thibault Schaeffer Lena Schoemig Urs Zenklusen Brigitta Gahl Oliver Reuthebuch Friedrich S. Eckstein Martin T. R. Grapow |
| author_sort | Constantin Mork |
| collection | DOAJ |
| description | Background. Single-dose cardioplegia is preferred in minimal invasive mitral valve surgery to maintain the adjustment of the operative site without change of preset visualization. The aim of our study was to compare two widely used crystalloid cardioplegias Bretschneider (Custodiol®) versus St. Thomas 2 in patients who underwent mitral valve repair via small anterolateral right thoracotomy. Material and Methods. From May 2012 until February 2019, 184 isolated mitral valve procedures for mitral valve repair via anterolateral right thoracotomy were performed using Bretschneider (Custodiol®) cardioplegia (n=123) or St. Thomas (n=61). Primary efficacy endpoint was peak postoperative high-sensitivity cardiac troponin (hs-cTnT) during hospitalization. Secondary endpoints were peak creatine kinase-muscle brain type (CK-MB) and creatine kinase (CK) as well as safety outcomes. We used inverse probability of treatment weighting (IPTW) in order to adjust for confounding by indication. Results. Peak hs-cTnT was higher after use of Bretschneider (Custodiol®) (geometric mean 716 mg/L, 95% confidence interval (CI) 605-847 mg/L) vs. St. Thomas 2 (561 mg/L, CI 467-674 mg/L, p=0.047). Peak CK-MB (geometric mean after Bretschneider (Custodiol®): 40 μg/L, CI 35-46, St. Thomas 2: 33 μg/L, CI 27-41, p=0.295) and CK (geometric mean after Bretschneider (Custodiol®): 1370 U/L, CI 1222-1536, St. Thomas 2: 1152 U/L, CI 972-1366, p=0.037) showed the same pattern. We did not see any difference with respect to postoperative complications between treatment groups after IPTW. Conclusion. Use of St. Thomas 2 cardioplegia was associated with lower postoperative peak levels of all cardiac markers that reflect cardiac ischemia such as hs-cTnT, CK, and CK-MB as compared to Bretschneider (Custodiol®) in propensity-weighted treatment groups. |
| format | Article |
| id | doaj-art-1ca35453ba214f8a8fb9008c4bf8e1f0 |
| institution | Kabale University |
| issn | 0962-9351 1466-1861 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Mediators of Inflammation |
| spelling | doaj-art-1ca35453ba214f8a8fb9008c4bf8e1f02025-08-20T03:54:37ZengWileyMediators of Inflammation0962-93511466-18612019-01-01201910.1155/2019/56480515648051Bretschneider (Custodiol®) and St. Thomas 2 Cardioplegia Solution in Mitral Valve Repair via Anterolateral Right Thoracotomy: A Propensity-Modelled ComparisonConstantin Mork0Luca Koechlin1Thibault Schaeffer2Lena Schoemig3Urs Zenklusen4Brigitta Gahl5Oliver Reuthebuch6Friedrich S. Eckstein7Martin T. R. Grapow8Department of Cardiac Surgery, University Hospital Basel, Basel, SwitzerlandDepartment of Cardiac Surgery, University Hospital Basel, Basel, SwitzerlandDepartment of Cardiac Surgery, University Hospital Basel, Basel, SwitzerlandDepartment of Cardiac Surgery, University Hospital Basel, Basel, SwitzerlandDepartment of Cardiac Surgery, University Hospital Basel, Basel, SwitzerlandDepartment of Cardiac Surgery, University Hospital Basel, Basel, SwitzerlandDepartment of Cardiac Surgery, University Hospital Basel, Basel, SwitzerlandDepartment of Cardiac Surgery, University Hospital Basel, Basel, SwitzerlandDepartment of Cardiac Surgery, University Hospital Basel, Basel, SwitzerlandBackground. Single-dose cardioplegia is preferred in minimal invasive mitral valve surgery to maintain the adjustment of the operative site without change of preset visualization. The aim of our study was to compare two widely used crystalloid cardioplegias Bretschneider (Custodiol®) versus St. Thomas 2 in patients who underwent mitral valve repair via small anterolateral right thoracotomy. Material and Methods. From May 2012 until February 2019, 184 isolated mitral valve procedures for mitral valve repair via anterolateral right thoracotomy were performed using Bretschneider (Custodiol®) cardioplegia (n=123) or St. Thomas (n=61). Primary efficacy endpoint was peak postoperative high-sensitivity cardiac troponin (hs-cTnT) during hospitalization. Secondary endpoints were peak creatine kinase-muscle brain type (CK-MB) and creatine kinase (CK) as well as safety outcomes. We used inverse probability of treatment weighting (IPTW) in order to adjust for confounding by indication. Results. Peak hs-cTnT was higher after use of Bretschneider (Custodiol®) (geometric mean 716 mg/L, 95% confidence interval (CI) 605-847 mg/L) vs. St. Thomas 2 (561 mg/L, CI 467-674 mg/L, p=0.047). Peak CK-MB (geometric mean after Bretschneider (Custodiol®): 40 μg/L, CI 35-46, St. Thomas 2: 33 μg/L, CI 27-41, p=0.295) and CK (geometric mean after Bretschneider (Custodiol®): 1370 U/L, CI 1222-1536, St. Thomas 2: 1152 U/L, CI 972-1366, p=0.037) showed the same pattern. We did not see any difference with respect to postoperative complications between treatment groups after IPTW. Conclusion. Use of St. Thomas 2 cardioplegia was associated with lower postoperative peak levels of all cardiac markers that reflect cardiac ischemia such as hs-cTnT, CK, and CK-MB as compared to Bretschneider (Custodiol®) in propensity-weighted treatment groups.http://dx.doi.org/10.1155/2019/5648051 |
| spellingShingle | Constantin Mork Luca Koechlin Thibault Schaeffer Lena Schoemig Urs Zenklusen Brigitta Gahl Oliver Reuthebuch Friedrich S. Eckstein Martin T. R. Grapow Bretschneider (Custodiol®) and St. Thomas 2 Cardioplegia Solution in Mitral Valve Repair via Anterolateral Right Thoracotomy: A Propensity-Modelled Comparison Mediators of Inflammation |
| title | Bretschneider (Custodiol®) and St. Thomas 2 Cardioplegia Solution in Mitral Valve Repair via Anterolateral Right Thoracotomy: A Propensity-Modelled Comparison |
| title_full | Bretschneider (Custodiol®) and St. Thomas 2 Cardioplegia Solution in Mitral Valve Repair via Anterolateral Right Thoracotomy: A Propensity-Modelled Comparison |
| title_fullStr | Bretschneider (Custodiol®) and St. Thomas 2 Cardioplegia Solution in Mitral Valve Repair via Anterolateral Right Thoracotomy: A Propensity-Modelled Comparison |
| title_full_unstemmed | Bretschneider (Custodiol®) and St. Thomas 2 Cardioplegia Solution in Mitral Valve Repair via Anterolateral Right Thoracotomy: A Propensity-Modelled Comparison |
| title_short | Bretschneider (Custodiol®) and St. Thomas 2 Cardioplegia Solution in Mitral Valve Repair via Anterolateral Right Thoracotomy: A Propensity-Modelled Comparison |
| title_sort | bretschneider custodiol r and st thomas 2 cardioplegia solution in mitral valve repair via anterolateral right thoracotomy a propensity modelled comparison |
| url | http://dx.doi.org/10.1155/2019/5648051 |
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