Tesi etd-10302018-152251
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Tipo di tesi
Corsi integrativi di I livello
Autore
BIAVATI, LUCA
URN
etd-10302018-152251
Titolo
Minimally Invasive Coronary Sinus Retrograde Cardioplegia in Cardiac Surgery: A Case-Control Study
Struttura
Cl. Sc. Sperimentali - Medicina
Corso di studi
SCIENZE MEDICHE - Medicina e chirurgia (DM 270)
Commissione
relatore Prof. RECCHIA, FABIO ANASTASIO
Membro Prof. PASSINO, CLAUDIO
Membro Prof. EMDIN, MICHELE
Membro Prof. LIONETTI, VINCENZO
Membro Dott.ssa ANGELONI, DEBORA
Membro Dott. MEOLA, MARIO
Membro Dott. PETRUCCI, ILARIA
Membro Prof. COCEANI, FLAVIO
Membro Prof. PASSINO, CLAUDIO
Membro Prof. EMDIN, MICHELE
Membro Prof. LIONETTI, VINCENZO
Membro Dott.ssa ANGELONI, DEBORA
Membro Dott. MEOLA, MARIO
Membro Dott. PETRUCCI, ILARIA
Membro Prof. COCEANI, FLAVIO
Parole chiave
- Nessuna parola chiave trovata
Data inizio appello
12/12/2018;
Disponibilità
completa
Riassunto analitico
Background. This study aimed to assess the safety and feasibility of percutaneous coronary sinus (CS) catheterization to administer retrograde cardioplegia in the setting of elective cardiac surgery.
Methods. In this retrospective case-control study, patients undergoing conventional aortic valve surgery with retrograde cardioplegia administered via percutaneous CS catheter were included (CSC group). CS catheter positioning was performed by a single anesthesiologist under echocardiographic and pressure guidance. Peri- and post-operative outcomes of the CSC group were compared to controls from the same study period after propensity score-matching.
Results. During the 2-years study period, CS catheterization was successful in 12 out of 13 patients (92.03%). A complication during positioning of the introducer in the internal jugular vein occurred in one case (7.7%). Retrograde cardioplegia was effectively administered in 11 (84.61%) patients because of anatomical abnormalities in one patient. Operative time was significantly longer in the CSC group (5.5 vs 4.5 hours, p < 0.01), although mechanical ventilation time (9 vs 8 hours, p > 0.50) and ICU length of stay (23.5 vs 23.0 hours, p > 0.50) were comparable between the two groups as were cardiopulmonary bypass and cross-clamping times (112 vs 109 minutes, p > 0.50 and 75 vs 78 minutes, p > 0.50, respectively). No difference in the incidence of major and minor post-operative complications and morbidities was observed. Overall mortality was identical in both groups.
Conclusions. Our study shows that minimally invasive CS catheterization for the administration of retrograde cardioplegia is safe and feasible and does not impact on peri- and post- operative outcomes.
Methods. In this retrospective case-control study, patients undergoing conventional aortic valve surgery with retrograde cardioplegia administered via percutaneous CS catheter were included (CSC group). CS catheter positioning was performed by a single anesthesiologist under echocardiographic and pressure guidance. Peri- and post-operative outcomes of the CSC group were compared to controls from the same study period after propensity score-matching.
Results. During the 2-years study period, CS catheterization was successful in 12 out of 13 patients (92.03%). A complication during positioning of the introducer in the internal jugular vein occurred in one case (7.7%). Retrograde cardioplegia was effectively administered in 11 (84.61%) patients because of anatomical abnormalities in one patient. Operative time was significantly longer in the CSC group (5.5 vs 4.5 hours, p < 0.01), although mechanical ventilation time (9 vs 8 hours, p > 0.50) and ICU length of stay (23.5 vs 23.0 hours, p > 0.50) were comparable between the two groups as were cardiopulmonary bypass and cross-clamping times (112 vs 109 minutes, p > 0.50 and 75 vs 78 minutes, p > 0.50, respectively). No difference in the incidence of major and minor post-operative complications and morbidities was observed. Overall mortality was identical in both groups.
Conclusions. Our study shows that minimally invasive CS catheterization for the administration of retrograde cardioplegia is safe and feasible and does not impact on peri- and post- operative outcomes.
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