P1809 Intraoperative myocardial protection in patients with septic endocarditis
Аннотация
Abstract Funding Acknowledgements there was not financial support OnBehalf cardiosurgery Introduction The choice of myocardial protection method in patients with septic endocarditis (SE) during heart surgery is currently controversial. The results of several studies have shown positive aspects of the use of crystalloid cardioplegia del Nido. However, the use of this method in adults is not sufficiently studied. Purpose.To determine the effectiveness of the use of crystalloid cardioplegia Del Nido in adult patients with septic endocarditis during a heart surgery with cardiopulmonary bypass. Methods We analyzed data of 100 patients with SE underwent surgical correction with cardiopulmonary bypass. There were 64 males and 36 females. Patients age ranged from 20 to 56 years (mean 44,4 ± 10,8years). The patients were divided into two groups: the main group (n = 50) with the use of cardioplegia Del Nido and the control group (n = 50) using conventional crystalloid cardioplegia. The dose of cardioplegia was 30 ml / kg for 1-2 minutes. Results Patients in the del Nido group required significantly less cardioplegia (1007,6 ± 347.3ml vs. 2450,4 ± 491,1ml, p < 0.001). The duration of asystole after clamping of the aorta in the main group lasted up to a maximum of 103 minutes, versus to the control group, where it was necessary to administer an additional dose every 25-30min, due to the appearance of spontaneous electrical activity of the heart. Both groups did not differ in the time of onset of asystole since the introduction of cardioplegia (1,62 ± 0.2min and 1,69 ± 0.3min). Cardiac activity was restored through the resolution of the complete blockade or through ventricular fibrillation. The frequency of rhythm disturbance (ventricular tachycardia, atrial fibrillation and ventricular fibrillation) was more often observed in the control group (25/50 – control group, 7/52 –main group, p < 0,005). The need for inotropic support was significantly less in the main group (10/50 main group, 20/50 control group). Postoperative mortality in the main group was lower (2%) compared with the control (13%). Conclusion Crystalloid cardioplegia del Nido provides better protection of the myocardium in adult patients with septic endocarditis and reduces postoperative cardiac rhythm disturbances and mortality.