PMID- 29290079
OWN - NLM
STAT- MEDLINE
DCOM- 20181029
LR  - 20181029
IS  - 1439-1902 (Electronic)
IS  - 0171-6425 (Linking)
VI  - 66
IP  - 6
DP  - 2018 Sep
TI  - Buckberg versus Calafiore Cardioplegia in Patients with Acute Coronary Syndromes.
PG  - 457-463
LID - 10.1055/s-0037-1612604 [doi]
AB  - BACKGROUND: Choice of cardioplegic solution plays a pivotal role in special 
      subgroups of patients referred for on-pump cardiac surgery. This retrospective 
      analysis aimed to assess the impact of intermittent warm (Calafiore, Cala) versus 
      intermittent cold blood cardioplegia (Buckberg, Buck) in patients referred to 
      coronary artery bypass graft (CABG) surgery due to acute coronary syndromes 
      (ACS). METHODS: From 2008 to 2015, all consecutive patients undergoing urgent 
      on-pump CABG surgery due to ACS (n = 950) were retrospectively analyzed. 
      Intraoperative cardiac arrest was achieved using Buck (n = 273) or Cala 
      (n = 677). Patients were compared regarding clinical outcomes and perioperative 
      myocardial injury (PMI). Propensity score matching was performed to control for 
      differences in preoperative patient characteristics. RESULTS: Prevalences of left 
      main stenosis >50%, COPD, and advanced New York Heart Association (NYHA) class 
      were higher for intermittent warm blood cardioplegia (IWC)-patients while more 
      Buck-patients had preoperative intra-aortic balloon pump (IABP) and redo 
      procedures. Buck-patients needed more intraoperative defibrillations and showed 
      longer cardiopulmonary bypass (CPB) and aortic clamping times. 30-day all-cause 
      mortality (10.6 versus 9.3%), major adverse cardiac events (MACE) (52.7 versus 
      48.6%), and PMI (50.5 versus 55.7%; all p > 0.05) rates were comparable for Buck- 
      and Cala-patients. Propensity score matching resulted in equal group sizes 
      (n = 212 each) and balanced distribution of preoperative covariates. Although 
      more Buck-patients still needed inotropic support >24 hours postoperatively (25.7 
      versus 14.7%; p = 0.005) compared with Cala-group, outcome variables of interest 
      did not differ between treatment groups (30-day mortality: 7.5 versus 9.0%; MACE: 
      49.5 versus 40.6%; PMI: 48.1 versus 37.3%; all p > 0.05). CONCLUSION: Buckberg 
      and Calafiore cardioplegia offer comparable myocardial protection and similar 
      postoperative results in patients undergoing CABG surgery due to ACS.
CI  - Georg Thieme Verlag KG Stuttgart . New York.
FAU - Kuhn, Elmar W
AU  - Kuhn EW
AD  - Department of Cardiothoracic Surgery, Heart Center of the University Hospital of 
      Cologne, Cologne, Germany.
FAU - Liakopoulos, Oliver
AU  - Liakopoulos O
AD  - Department of Cardiothoracic Surgery, Heart Center of the University Hospital of 
      Cologne, Cologne, Germany.
FAU - Slottosch, Ingo
AU  - Slottosch I
AD  - Department of Cardiothoracic Surgery, Heart Center of the University Hospital of 
      Cologne, Cologne, Germany.
FAU - Deppe, Antje Christin
AU  - Deppe AC
AD  - Department of Cardiothoracic Surgery, Heart Center of the University Hospital of 
      Cologne, Cologne, Germany.
FAU - Choi, Yeong-Hoon
AU  - Choi YH
AD  - Department of Cardiothoracic Surgery, Heart Center of the University Hospital of 
      Cologne, Cologne, Germany.
FAU - Madershahian, Navid
AU  - Madershahian N
AD  - Department of Cardiothoracic Surgery, Heart Center of the University Hospital of 
      Cologne, Cologne, Germany.
FAU - Wahlers, Thorsten C W
AU  - Wahlers TCW
AD  - Department of Cardiothoracic Surgery, Heart Center of the University Hospital of 
      Cologne, Cologne, Germany.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20171231
PL  - Germany
TA  - Thorac Cardiovasc Surg
JT  - The Thoracic and cardiovascular surgeon
JID - 7903387
RN  - 0 (Cardioplegic Solutions)
SB  - IM
MH  - Acute Coronary Syndrome/diagnosis/mortality/physiopathology/*surgery
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardioplegic Solutions/*administration & dosage/adverse effects
MH  - Cardiopulmonary Bypass
MH  - Chi-Square Distribution
MH  - Coronary Artery Bypass/adverse effects/*methods/mortality
MH  - Coronary Stenosis/diagnosis/mortality/physiopathology/*surgery
MH  - Female
MH  - Heart Arrest, Induced/adverse effects/*methods/mortality
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Operative Time
MH  - Postoperative Complications/etiology/therapy
MH  - Propensity Score
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Temperature
MH  - Time Factors
MH  - Treatment Outcome
COIS- None.
EDAT- 2018/01/01 06:00
MHDA- 2018/10/30 06:00
CRDT- 2018/01/01 06:00
PHST- 2018/01/01 06:00 [pubmed]
PHST- 2018/10/30 06:00 [medline]
PHST- 2018/01/01 06:00 [entrez]
AID - 10.1055/s-0037-1612604 [doi]
PST - ppublish
SO  - Thorac Cardiovasc Surg. 2018 Sep;66(6):457-463. doi: 10.1055/s-0037-1612604. Epub 
      2017 Dec 31.