Our Summary

This study looked at the effects of two different solutions, blood cardioplegia (BC) and del Nido cardioplegia (DNC), used during a specific heart surgery called coronary artery bypass grafting (CABG). The researchers wanted to see if there were any differences in early death rates or major adverse events (MAE), which include things like heart attacks, reoperations, strokes, and kidney failure.

They studied 329 patients who had the surgery at their clinic between 2016 and 2020. About 55% of these patients were treated with DNC and the rest with BC. They found no significant differences between the two groups in terms of age, weight, body surface area, gender, or risk level.

There was also no significant difference in the amount of time the heart was stopped during surgery (aortic cross-clamping time) between the two groups. However, they did find that the overall time on a heart-lung machine (cardiopulmonary bypass duration) was longer in the BC group. They also noticed that strokes were more common in the BC group.

But when they looked at the overall number of MAEs, death rates, time spent on a ventilator, time in the ICU, and length of hospital stay, there was no significant difference between the two groups.

In conclusion, the researchers believe that both BC and DNC solutions can be used safely for protecting the heart during CABG in adult patients.

FAQs

  1. What are blood cardioplegia (BC) and del Nido cardioplegia (DNC) solutions and how are they used in coronary artery bypass grafting (CABG)?
  2. Were there any significant differences found in the study between the patients treated with DNC and those treated with BC in terms of early death rates or major adverse events (MAE)?
  3. Did the use of BC or DNC solutions have any significant impact on the length of time spent on a heart-lung machine, or on the incidence of strokes in patients undergoing CABG?

Doctor’s Tip

A helpful tip a doctor might tell a patient about heart bypass surgery is to discuss with their healthcare team the type of cardioplegia solution that will be used during the procedure. It’s important to understand the potential benefits and risks associated with different options in order to make an informed decision about your treatment. Additionally, following post-operative care instructions and attending regular follow-up appointments are key to a successful recovery after heart bypass surgery.

Suitable For

Patients who are typically recommended heart bypass surgery are those with significant blockages in their coronary arteries that cannot be treated with medications or less invasive procedures like angioplasty. These patients may have symptoms such as chest pain (angina), shortness of breath, or fatigue due to poor blood flow to the heart muscle. Additionally, patients with a history of heart attacks, unstable angina, or other high-risk factors for cardiovascular disease may also be recommended for heart bypass surgery.

Timeline

Before heart bypass surgery, a patient typically undergoes a series of tests and evaluations to determine the severity of their heart disease and if they are a candidate for the procedure. This may include a physical examination, blood tests, imaging tests such as an echocardiogram or stress test, and possibly a coronary angiogram to visualize blockages in the arteries.

After the decision is made to proceed with heart bypass surgery, the patient will be admitted to the hospital on the day of the procedure. The surgery itself involves creating new pathways for blood to flow around blocked or narrowed arteries in the heart. This is typically done by taking a blood vessel from another part of the body, such as the chest or leg, and attaching it to the coronary artery to bypass the blockage.

Following the surgery, the patient will be monitored closely in the intensive care unit (ICU) before being transferred to a regular hospital room. Recovery from heart bypass surgery can take several weeks and may involve cardiac rehabilitation to regain strength and improve cardiovascular health. Patients will also need to make lifestyle changes, such as adopting a heart-healthy diet and participating in regular exercise, to reduce the risk of future heart problems.

What to Ask Your Doctor

Some questions a patient should ask their doctor about heart bypass surgery include:

  1. What are the potential risks and complications associated with the surgery?
  2. What type of cardioplegia solution will be used during the surgery, and why?
  3. Are there any alternative treatment options to consider?
  4. How long will the recovery process take, and what can I expect during that time?
  5. What lifestyle changes will I need to make after the surgery?
  6. How frequently will follow-up appointments be needed, and what will they entail?
  7. What signs or symptoms should I watch for that may indicate a complication or need for medical attention?
  8. Are there any specific medications I will need to take after the surgery?
  9. How can I best prepare for the surgery in terms of physical and mental health?
  10. Can you provide more information about your experience and success rates with this procedure?

Reference

Authors: Özkara T, Kayğın MA, Ergün S, Limandal HK, Diler MS, Dayı HIÇ, Yıldız Z, Dağ Ö. Journal: Braz J Cardiovasc Surg. 2023 Apr 23;38(2):259-264. doi: 10.21470/1678-9741-2022-0093. PMID: 36459478