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  1. Eng JB
    Med J Malaysia, 2007 Jun;62(2):177-8.
    PMID: 18705461 MyJurnal
    A 58 year-old man presented with a large aneurysm of the aortic arch and severe coronary artery disease. He underwent combined repair of the aortic arch aneurysm and coronary artery bypass grafting via a modified clamshell incision using deep hypothermic circulatory arrest and retrograde cerebral perfusion. He made an uncomplicated postoperative recovery. The operative techniques are discussed with a review of the relevant literature.
    Matched MeSH terms: Heart Arrest, Induced
  2. Haranal M, Chin HC, Sivalingam S, Raja N, Mohammad Shaffie MS, Namasiwayam TK, et al.
    World J Pediatr Congenit Heart Surg, 2020 Nov;11(6):720-726.
    PMID: 33164692 DOI: 10.1177/2150135120936119
    BACKGROUND: To compare the safety and effectiveness of del Nido cardioplegia with blood-based St Thomas Hospital (BSTH) cardioplegia in myocardial protection in congenital heart surgery.

    METHODS: It is a prospective, open-labeled, randomized controlled study conducted at National Heart Institute, Kuala Lumpur from July 2018 to July 2019. All patients with simple and complex congenital heart diseases (CHD) with good left ventricular function (left ventricular ejection fraction [LVEF] >50%) were included while those with LVEF <50% were excluded. A total of 100 patients were randomized into two groups of 50 each receiving either del Nido or BSTH cardioplegia. Primary end points were the spontaneous return of activity following aortic cross-clamp release and ventricular function between two groups. Secondary end point was myocardial injury as assessed by troponin T levels.

    RESULTS: Cardiopulmonary bypass and aortic cross-clamp time, return of spontaneous cardiac activity following the aortic cross-clamp release, the duration of mechanical ventilation, and intensive care unit stay were comparable between two groups. Statistically significant difference was seen in the amount and number of cardioplegia doses delivered (P < .001). The hemodilution was significantly less in the del Nido complex CHD group compared to BSTH cardioplegia (P = .001) but no difference in blood usage (P = .36). The myocardial injury was lesser (lower troponin T release) with del Nido compared to BSTH cardioplegia (P = .6).

    CONCLUSION: Our study showed that both del Nido and BSTH cardioplegia are comparable in terms of myocardial protection. However, single, less frequent, and lesser volume of del Nido cardioplegia makes it more suitable for complex repair.

    Matched MeSH terms: Heart Arrest, Induced
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