Comparative Study between Bretschneider Cardioplegia and Warm Blood Cardioplegia on Myocardial Protection in Patients with Ischemic Mitral Regurgitation

Mohamed, Mohamed; Gamil, Elhusseiny; Mazen, Mahmoud; Aboalazayem, Hatem

doi:10.58675/2682-339X.2529

	Comparative Study between Bretschneider Cardioplegia and Warm Blood Cardioplegia on Myocardial Protection in Patients with Ischemic Mitral Regurgitation
Al-Azhar International Medical Journal
Volume 2024, Issue 7, July 2024
DOI: 10.58675/2682-339X.2529
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Authors
Mohamed Mohamed¹; Elhusseiny Gamil²; Mahmoud Mazen¹; Hatem Aboalazayem²
¹Cardiothoracic surgery, National Heart Institute, Cairo, Egypt
²Cardiothoracic surgery, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt
Abstract
Background: The ideal approach for myocardial preservation during ischemic cardiac arrest remains controversial. One dosage of cardioplegia for preservation of the myocardium is advocated in protracted surgeries. Aim: To explore the effects of Bretschneider cardioplegia and warm blood cardioplegia on myocardial protection in patients with ischemic mitral regurgitation following coronary artery bypass graft surgery with mitral valve replacement. Patient and Methods: This prospective study included 60 patients from the cardiothoracic surgery department at El-Hussein University Hospital and the National Heart Institute. The patients were divided into two groups: (A) thirty patients received Bretschneider cardioplegia, and (B) thirty patients received warm blood cardioplegia. Data from both groups were assembled and compared. Results: The mean CPB time in the Bretschneider group was 103.67 ± 30.57, while in the warm blood cardioplegia group, it was 121.73 ± 33.98 minutes. The mean of intensive care unit stays in the Bretschneider group was 2.70 ± 0.75 days, whilst in the warm blood cardioplegia group was 3.40 ± 1.07 days, the mean period of the mechanical ventilation in the Bretschneider group was 7 (6 – 9) while in warm blood cardioplegia group was 12 (10 - 18) hours. Troponin elevated: The Bretschneider group was in 3 patients (10%), while the warm blood group was in 19 patients (63.3%). Conclusion: Bretschneider's cardioplegia solution showed superiority in myocardial protection, reducing CPB and CCT, fewer inotropes used, less mechanical ventilation time, and less elevation of cardiac enzymes, resulting in reduced ICU and hospital stay.


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