Benefits of custodiol cardioplegia in the context of cardiac surgery training

• Published in: The Egyptian journal of surgery : official organ of the Egyptian Society of Surgeons = Majallat al-jirāhah al-Misrīyah Vol. 40; no. 4; pp. 1338 - 1342
• Main Authors: Elnahas, Ashraf, Abdelgawad, Basem, Ali, Mohamed, Khedr, Amany, Sobhy, Mohamed, Omar, Ihab
• Format: Journal Article
• Language: English
• Published: Wolters Kluwer India Pvt. Ltd 01.10.2021; Medknow Publications and Media Pvt. Ltd
• Subjects: Homeopathy; Materia medica and therapeutics; Surgery; Therapeutics; histidine-tryptophan-ketoglutarate solution; cold-blood cardioplegia; custodial; coronary artery bypass grafting
• ISSN: 1110-1121; 1687-7624
• DOI: 10.4103/ejs.ejs_233_21

Context The need for competent surgeons to provide high-quality surgical interventions is crucial. The challenge of worsening the outcome has a great negative impact on the rate of training, especially in complex or long-duration procedures. Custodiol cardioplegia is an attractive solution for many cardiac surgeons, as a single dose provides a long period of myocardial protection. Aims We aimed to evaluate the benefit of custodiol cardioplegia in comparison with the conventional one in supporting training programs. Settings and design A retrospective study was conducted in the period from March 2016 to January 2021. The study included 240 adult patients who underwent open-heart surgeries and required cardioplegia and cardiopulmonary bypass. Patients and methods Patients were divided into two groups: group A (120 patients) received conventional cardioplegia. Group B (120 patients) received custodial cardioplegia. Statistical analysis used The patient's data were analyzed using the Statistical Package for Social Sciences (SPSS), version 21 for Windows (SPSS Inc., Chicago, Illinois, USA). Comparison between groups was done by χ2 test. Quantitative data were presented as mean±SD. Qualitative data were presented as numbers and percentages. Student t test and χ2 test were used to compare between two groups. A P value less than 0.05 was considered statistically significant. Results The preoperative patient characteristics were comparable among both groups regarding the demographic data, the comorbidities, and cardiac parameters. There was a significant difference between both groups in cross-clamp (133.35 vs. 124.81 min) and total bypass (162.41 vs. 154.7 min) times (P<0.001). The mechanical ventilation, intensive care, and hospital stay times were significantly prolonged in the conventional group (P<0.05). The 30-day mortality was lower in the custodial group but was not significant (P=0.207). Conclusion The use of custodiol is more effective than cold cardioplegia in protecting the myocardium and thus supporting training programs.