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http://hdl.handle.net/1942/4499
Title: | Continuous retrograde blood cardioplegia is associated with lower hospital mortality after heart valve surgery | Authors: | Flameng, W.J. Herijgers, P. DEWILDE, Sylvia LESAFFRE, Emmanuel |
Issue Date: | 2003 | Publisher: | MOSBY, INC | Source: | The journal of thoracic and cardiovascular surgery, 125(1). p. 121-125 | Abstract: | Objective: Myocardial preservation studies comparing blood and crystalloid cardioplegia techniques were almost exclusively performed on patients undergoing coronary bypass, and they were unable to show a difference in hospital mortality. We investigated possible factors, including cardioplegia techniques, influencing hospital mortality in patients undergoing cardiac valve surgery. Methods: We evaluated hospital mortality in 1098 consecutive patients undergoing cardiac valve surgery by using a multivariate logistic regression with propensity score balancing of the groups. In 25% of the patients, multiple valve or Bentall procedures were performed, and in 46% of all patients, coronary bypass grafting was associated with valve surgery. A first cohort of 504 consecutive patients were operated on by using single-shot antegrade cold crystalloid cardioplegia, and a second cohort of 594 patients were operated on by using continuous retrograde cold blood cardioplegia. Results: After correction for patient-related and operative risk factors, lower hospital mortality was found in patients who received retrograde blood cardioplegia (P = .020). The odds ratio of in-hospital death when using blood cardioplegia was 0.44 (95% confidence interval, 0.22-0.88). Further predictors of hospital mortality were age, advanced New York Heart Association functional class, cardiopulmonary bypass time, reoperation, active endocarditis, and renal failure. Conclusions: This study shows that continuous retrograde blood cardioplegia is associated with lower hospital mortality in heart valve operations. | Document URI: | http://hdl.handle.net/1942/4499 | ISSN: | 0022-5223 | e-ISSN: | 1097-685X | DOI: | 10.1067/mtc.2003.77 | ISI #: | 000180579300023 | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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