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Document Type

Original Article

Abstract

Background: Cardioplegia is necessary during heart surgery to lessen the myocardium's metabolic needs and avoid osmotic, electrolytic, and pH imbalances. Methodology: This prospective non-randomized controlled clinical trial was conducted at cardiothoracic surgery department - Faculty of Medicine – Al-Azhar University from October 2019 until December 2022. During this study, 60 patients were assessed for eligibility and divided into two equal groups; group A included patients who were given a single dose of antegrade custodial cardioplegia with moderate hypothermia 30°C, to be repeated after 3hours and group B included patients who were given intermittent antegrade cold blood cardioplegia with moderate hypothermia to be repeated every 20-25 min. All patients were evaluated preoperatively, intraoperatively, and postoperatively and particular attention was paid to all surgical problems and postoperative complications related to the technique of myocardial protection. Results: Cardiopulmonary bypass time and return of spontaneous rhythm after Defibrillator Device (DC) shock were statistically significant lower (145.86 ± 28.56) versus (165.24 ± 27.54) minutes and 10 (33.3%) versus 18 (60.0%) respectively among group A compared with group B. Conclusion: In the surgical repair or replacement of double valve lesions, cold histidine-tryptophan-ketoglutarate solution (HTK) demonstrated greater myocardial preservation than hypothermic hyperkalemic blood cardioplegia.

Keywords

Custodiol; Blood-enriched Cardioplegia; Myocardial Protection; Double Valve Surgery.

Subject Area

Thoracic and cardiovascular surgery

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