The effects of St. Thomas I and St. Thomas II Cardioplegia Solutions on Coronary Sinus Lactate in Mitral Valve Surgery; A Randomized, Double-blinded, Clinical Trial

Document Type : Original Article

Authors

1 Department of Extra-Corporeal Circulation (ECC), Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

3 Department of Anesthesiology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

4 Department of Critical Care, Razavi Hospital, Mashhad, Iran

5 Department of Extra-Corporeal Circulation (ECC), Razavi Hospital, Mashhad, Iran

Abstract

Background: Cardiac protection strategies in different methods are challenging and crucial, affecting postoperative morbidity and mortality.
 
Objectives: We compared the cardio-protective effect of two cardioplegia solutions based on coronary sinus lactate levels.
 
Methods: This randomized, double-blinded clinical trial study was performed on 46 candidates for mitral valve replacement between June 2020 and January 2021. The patients were categorized via block randomization method: 1) St. Thomas I cardioplegia (n=23) and St. Thomas Ⅱ cardioplegia (n=23). The coronary sinus lactate levels at different times were measured. In addition, some intra-operative and clinical characteristics after cardiac surgery were recorded. Data were analyzed in SPSS software (version 26.0) using paired and independent t-tests, repeated measure ANOVA, and Pearson correlation test at a significance level of P < 0.05.
 
Results: In the time trend, the lactate levels in patients with St. Thomas Ⅱ cardioplegia solution had a significantly lower rate than in St. Thomas I (P=0.001). The two groups displayed no statistical difference between the aortic cross-clamp time (P=0.069) and the CPB time (P=0.091). Furthermore, the weaning from mechanical ventilation (P=0.078) and ICU stay (P=0.061) demonstrated no statistical difference between the study groups.
 
Conclusion: Based on significantly lower measures of the coronary sinus lactate, the St. Thomas Ⅱ cardioplegia solution showed a better cardio-protective effect in patients undergoing mitral valve surgery.
 

Keywords

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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Razavi International Journal of Medicine
Volume 11, Issue 3
August 2023
Pages 12-16

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