Tesi etd-10302018-152251
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Type of thesis
Corsi integrativi di I livello
Author
BIAVATI, LUCA
URN
etd-10302018-152251
Title
Minimally Invasive Coronary Sinus Retrograde Cardioplegia in Cardiac Surgery: A Case-Control Study
Structure
Cl. Sc. Sperimentali - Medicina
Course
SCIENZE MEDICHE - Medicina e chirurgia (DM 270)
Committee
relatore Prof. RECCHIA, FABIO ANASTASIO
Keywords
- Nessuna parola chiave trovata
Exam session start date
12/12/2018;
Availability
completa
Abstract
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.<br>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.<br>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.<br>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.<br>
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