Universität zu Köln

Kuhn, Elmar W., Liakopoulos, Oliver, Slottosch, Ingo, Deppe, Antje Christin, Choi, Yeong-Hoon, Madershahian, Navid and Wahlers, Thorsten C. W. (2018). Buckberg versus Calafiore Cardioplegia in Patients with Acute Coronary Syndromes. Thorac. Cardiovasc. Surg., 66 (6). S. 457 - 464. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1439-1902

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Abstract

Background Choice of cardioplegic solution plays a pivotal role in special subgroups of patients referred for on-pump cardiac surgery. This retrospective analysis aimed to assess the impact of intermittent warm(Calafiore, Cala) versus intermittent cold blood cardioplegia (Buckberg, Buck) in patients referred to coronary artery bypass graft (CABG) surgery due to acute coronary syndromes (ACS). Methods From 2008 to 2015, all consecutive patients undergoing urgent on-pump CABG surgery due to ACS (n = 950) were retrospectively analyzed. Intraoperative cardiac arrest was achieved using Buck (n = 273) or Cala (n = 677). Patients were compared regarding clinical outcomes and perioperative myocardial injury (PMI). Propensity score matching was performed to control for differences in preoperative patient characteristics. Results Prevalences of left main stenosis > 50%, COPD, and advanced New York Heart Association (NYHA) class were higher for intermittent warm blood cardioplegia (IWC)-patients while more Buck-patients had preoperative intra-aortic balloon pump (IABP) and redo procedures. Buck-patients needed more intraoperative defibrillations and showed longer cardiopulmonary bypass (CPB) and aortic clamping times. 30-day all-cause mortality (10.6 versus 9.3%), major adverse cardiac events (MACE) (52.7 versus 48.6%), and PMI (50.5 versus 55.7%; all p > 0.05) rates were comparable for Buck- and Cala-patients. Propensity score matching resulted in equal group sizes (n = 212 each) and balanced distribution of preoperative covariates. Although more Buck-patients still needed inotropic support > 24 hours postoperatively (25.7 versus 14.7%; p = 0.005) compared with Cala-group, outcome variables of interest did not differ between treatment groups (30-day mortality: 7.5 versus 9.0%; MACE: 49.5 versus 40.6%; PMI: 48.1 versus 37.3%; all p > 0.05). Conclusion Buckberg and Calafiore cardioplegia offer comparable myocardial protection and similar postoperative results in patients undergoing CABG surgery due to ACS.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kuhn, Elmar W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Liakopoulos, Oliver UNSPECIFIED UNSPECIFIED UNSPECIFIED Slottosch, Ingo UNSPECIFIED UNSPECIFIED UNSPECIFIED Deppe, Antje Christin UNSPECIFIED UNSPECIFIED UNSPECIFIED Choi, Yeong-Hoon UNSPECIFIED UNSPECIFIED UNSPECIFIED Madershahian, Navid UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten C. W. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-173963
DOI:	10.1055/s-0037-1612604
Journal or Publication Title:	Thorac. Cardiovasc. Surg.
Volume:	66
Number:	6
Page Range:	S. 457 - 464
Date:	2018
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1439-1902
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BLOOD CARDIOPLEGIA; INTERMITTENT COLD; CLINICAL-OUTCOMES; HEART-SURGERY; WARM Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17396