Ahmed Sobhy AbdAllah Mohamed Emara
Professor
Clinical Outcomes of the Use of Custodiol versus Warm Blood Cardioplegia during Coronary Artery Bypass Grafting in Patients with Significant Left Main Coronary Artery Disease
• 2024
Publication Information
Authors
Ahmed Sobhy Emara1
, Yousry Elsaid Rezk1
, Ibrahim Mohammed Reda Kasab1
, Basem
Mofreh Aglan1
, Ahmed Elsayed Ahmed Elkafoury2
, Abdelhamid Fathi Sherif1
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publication.type
Local
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Abstract
Background: Patients who undergo coronary artery bypass graft (CABG) surgery,
particularly those with significant left main coronary artery disease (LMCAD),
require optimal myocardial protection. The selection between Custodiol and warm
blood cardioplegia remains critical in enhancing surgical outcomes and improving
postoperative quality of life. This study sought to compare Custodiol and warm
blood cardioplegia regarding myocardial protection during CABG surgery.
Methods: This randomized controlled clinical trial was carried out on 100 patients
with significant LMCAD. Patients underwent CABG surgery using either Custodiol
(Group I, n= 50) or intermittent antegrade warm blood cardioplegia (Group II, n=
50). In Group I, 13 patients were female (26%); in Group II, 15 were female (30%).
Results: Both groups had comparable preoperative demographics. Use of
hemofilter [8 (16%) vs. 1 (2%), p= 0.004], DC shock [ 6 (12%) vs. 1 (2%), p= 0.037]
were more common in Group I. Arrhythmia occurred more frequently in Group I
intraoperatively [ 9 (18%) vs. 2 (4%), p= 0.009]. No early mortality was observed in
either group. Postoperative data revealed no significant differences between the
groups in vital parameters, complications, echocardiographic data, or mortality.
Conclusion: Both Custodiol and warm blood cardioplegia demonstrated
comparable efficacy and safety profiles for myocardial preservation during CABG
surgery in patients with significant LMCAD. Custodiol could be an effective
alternative to blood cardioplegia in patients with LMCAD.
particularly those with significant left main coronary artery disease (LMCAD),
require optimal myocardial protection. The selection between Custodiol and warm
blood cardioplegia remains critical in enhancing surgical outcomes and improving
postoperative quality of life. This study sought to compare Custodiol and warm
blood cardioplegia regarding myocardial protection during CABG surgery.
Methods: This randomized controlled clinical trial was carried out on 100 patients
with significant LMCAD. Patients underwent CABG surgery using either Custodiol
(Group I, n= 50) or intermittent antegrade warm blood cardioplegia (Group II, n=
50). In Group I, 13 patients were female (26%); in Group II, 15 were female (30%).
Results: Both groups had comparable preoperative demographics. Use of
hemofilter [8 (16%) vs. 1 (2%), p= 0.004], DC shock [ 6 (12%) vs. 1 (2%), p= 0.037]
were more common in Group I. Arrhythmia occurred more frequently in Group I
intraoperatively [ 9 (18%) vs. 2 (4%), p= 0.009]. No early mortality was observed in
either group. Postoperative data revealed no significant differences between the
groups in vital parameters, complications, echocardiographic data, or mortality.
Conclusion: Both Custodiol and warm blood cardioplegia demonstrated
comparable efficacy and safety profiles for myocardial preservation during CABG
surgery in patients with significant LMCAD. Custodiol could be an effective
alternative to blood cardioplegia in patients with LMCAD.