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.