Data collection, design and study outcomes
This is a retrospective observational study. Clinical, operative and outcome data were collected prospectively in a computerized database and all consecutive patients (July/2017-November/2019) undergoing open cardiac surgery procedures by one surgeon (KDA) were selected from the database and included in this study (N=305). Procedures included: isolated coronary artery bypass grafting (CABG); isolated single, double, and triple valve surgery; combined CABG and valve(s) procedures as well as other procedures such as aortic dissection, aortic root replacement and surgery for mechanical complications of myocardial infarction. Both first time and redo procedures (including multiple redo procedures) were included. The only pump procedures that were excluded are: heart transplantations.
Our purpose is to compare short term clinical outcomes between cold blood cardioplegia (BC) and DNC in a wide range of adult cardiac surgery procedures, both low and high risks. The study was approved by our institutional research ethics board and individual’s consent for study was waived. The DNC was adopted as a routine cardioplegia for all adult cardiac surgery procedures in our center in July/ 2017 and was used preferentially whenever is available. If DNC was not available due to supply shortage, our conventional multidose cold BC is used.
The primary outcome was hospital mortality which was defined as any postoperative death in hospital. Secondary postoperative outcomes included: Stroke, requirement for extracorporeal membrane oxygenation (ECMO), troponin levels, aortic cross clamp and cardiopulmonary (CPB) bypass times and cardioplegia volume and number of cardioplegia doses.