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dc.creatorCvetković, Dragan
dc.creatorKočica, Mladen
dc.creatorŠoškić, Ljiljana
dc.creatorVučićević, Filip
dc.creatorPetrović, Olga
dc.creatorJovanović, Ivana
dc.creatorJovičić, Snežana
dc.creatorTrifković, Jelena
dc.creatorKostovski, Saša
dc.creatorMiličić, Biljana
dc.creatorKaradžić, Milica
dc.creatorRistić, Arsen
dc.creatorSavić, Dragutin
dc.date.accessioned2021-01-20T23:03:50Z
dc.date.available2021-01-20T23:03:50Z
dc.date.issued2020
dc.identifier.issn0042-8450
dc.identifier.urihttp://cherry.chem.bg.ac.rs/handle/123456789/4307
dc.description.abstractBackground/Aim. Custodiol® is a hyperpolarizing cardioplegic solution which has been used in our national cardiac surgical practice exclusively for the heart transplant surgery. Owing to its numerous advantages over the standard depolarizing solutions, Custodiol® became cardioplegic solution of choice for all other cardiac surgical procedures in many cardio-surgical centers. This study evaluated myocardial protection by Custodiol® compared to modified St. Thomas cardioplegic solution in coronary artery bypass surgery. Methods. In a prospective four-month study, 110 consecutive adult patients who underwent primary isolated elective on-pump coronary artery bypass grafting (CABG) were randomized into the Custodiol® group (n = 54) and the St. Thomas groupa (n = 50), based on the type of administered cardioplegia; six patients were excluded. Cardiac protection was achieved as antegrade cold crystalloid cardioplegia by one of the solutions. Myocardial preservation was assessed through following outcomes: spontaneous rhythm restoration post cross-clamp, and postpoperative cardiac specific enzymes level, ejection fraction (EF) change, inotropic support, myocardial infarction (MI), atrial fibrillation (AF), and death. Results. Preoperative and intraoperative characteristics of patients in both groups were similar except for a considerably longer cross-clamp time in the Custodiol® group (49.1 ± 19.0 vs. 41.0 ± 12.9 minutes; p = 0.022). The Custodiol® group exhibited a higher rate of return to spontaneous rhythm compared to the St. Thomas group (31.5% vs. 20.0%, respectively; p = 0.267), lower rates of AF (20.4% vs. 28%, respectively; p = 0.496), MI (1.8% vs. 10.0%, respectively; p = 0.075) and inotropic support (9.0% vs. 12.0%, respectively; p = 0.651), albeit not statistically significant. There was an insignificant difference in peak value of troponin I between the Custodiol® and Thee St. Thomas group (5.0 ± 3.92 μg/L vs. 4.5 ± 3.39 μg/L, respectively; p = 0.755) and creatine kinase-MB (26.9 ± 15.4 μg/L vs. 28.5 ± 24.2 μg/L, respectively; p = 0.646) 6 hours post-surgery. EF reduction was comparable (0.81% vs. 1.26%; p = 0.891). There were no deaths in both groups. Conclusions. Custodiol® and modified St.Thomas cardioplegic solution have comparable cardioprotective effects in CABG surgery. The trends of less frequent MI, AF and ino-tropic support, despite the longer cross-clamp time in the Custodiol® group may suggest that its benefits could be ascertained in a larger study.
dc.rightsopenAccess
dc.sourceVojnosanitetski pregled
dc.subjectheart arrest
dc.subjectinduced
dc.subjectcustodiol-n solution
dc.subjectcardiac surgical procedures
dc.subjectpostoperative period
dc.subjectarrhythmias
dc.subjectcardiac
dc.subjectheart function tests
dc.subjectmortality
dc.titleComparison of Custodiol® and modified St. Thomas cardioplegia for myocardial protection in coronary artery bypass grafting
dc.typearticleen
dc.rights.licenseBY-SA
dcterms.abstractКараджић, Милица; Савић, Драгутин; Ристић, Aрсен; Јовановић, Ивана; Трифковић, Јелена; Миличић, Биљана; Цветковић, Драган; Кочица, Младен; Шошкић, Љиљана; Вучићевић, Филип; Петровић, Олга; Јовичић, Снежана; Костовски, Саша;
dc.citation.volume77
dc.citation.issue11
dc.citation.spage1126
dc.citation.epage1134
dc.identifier.wos000596871900002
dc.identifier.doi10.2298/VSP181108192C
dc.citation.rankM23~
dc.type.versionpublishedVersion
dc.identifier.scopus2-s2.0-85098755057
dc.identifier.fulltexthttp://cherry.chem.bg.ac.rs/bitstream/id/26538/Comparison_of_Custodiol_pub_2020.pdf


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