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KMID : 1164620200530060375
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Korean Journal of Thoracic and Cardiovascular Surgery
2020 Volume.53 No. 6 p.375 ~ p.380
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The Effect of Supplemental Cardioplegia Infusion before Anastomosis in Patients Undergoing Heart Transplantation with Long Ischemic Times
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Kim Hong-Rae
Jung Sung-Ho
Yang Jun-Ho
Kim Min-Su
Yun Tae-Jin
Kim Jae-Joong
Lee Jae-Won
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Abstract
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Background: Prolonged ischemic time is a risk factor for primary graft dysfunction in patients who undergo heart transplantation. We investigated the effect of a supplemental cardioplegia infusion before anastomosis in patients with long ischemic times.
Methods: We identified 236 consecutive patients who underwent orthotopic heart transplantation between February 2010 and December 2014. Among them, the patients with total ischemic times of longer than 3 hours (n=59) were categorized based on whether they were administered a complementary cardioplegia solution (CPS) immediately before implantation (CPS+, n=30; CPS?, n=29).
Results: The mean total ischemic times in the CPS+ and CPS? groups were 238.1±30.1 minutes and 230.1±28.2 minutes, respectively (p=0.3). The incidence of left ventricular primary graft dysfunction (CPS+, n=6 [20.0%]; CPS?, n=5 [17.2%]; p=0.79) was comparable between the groups. In the Kaplan-Meier survival analysis, no significant difference in overall survival at 5 years was observed between the CPS+ and CPS? groups (83.1%±6.9% vs. 89.7%±5.7%, respectively; log-rank p=0.7). No inter-group differences in early mortality (CPS+, n=0; CPS?, n=1 [3.4%]; p=0.98) or complications were observed.
Conclusion: The additional infusion of a cardioplegia solution immediately before implantation in patients with longer ischemic times is a simple, reproducible, and safe procedure. However, we did not observe benefits of this strategy in the present study.
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KEYWORD
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Heart transplantation, Induced heart arrest, Primary graft dysfunction, Cold ischemia
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