TY - JOUR AU - Koechlin, Luca; Rrahmani, Bejtush; Gahl, Brigitta; Berdajs, Denis; Grapow, Martin T.R.; Eckstein, Friedrich S.; Reuthebuch, Oliver TI - Microplegia versus Cardioplexol® in Coronary Artery Bypass Surgery with Minimal Extracorporeal Circulation: Comparison of Two Cardioplegia Concepts SN - 0171-6425 SN - 1439-1902 PY - 2020 JO - Thorac Cardiovasc Surg JF - The Thoracic and Cardiovascular Surgeon LA - EN VL - 68 IS - 03 SP - 223 EP - 231 ET - 2019/04/25 DA - 2020/04/08 KW - cardiopulmonary bypass (CPB) KW - coronary artery bypass grafts surgery (CABG) KW - myocardial protection/cardioplegia KW - perfusion AB - Background The aim of this study is to compare the combined use of the Myocardial Protection System and our microplegia (Basel Microplegia Protocol) with Cardioplexol® in coronary artery bypass grafting using the minimal extracorporeal circulation.Methods The analysis focused on propensity score matched pairs of patients in whom microplegia or Cardioplexol® was used. Primary efficacy endpoints were high-sensitivity cardiac troponin-T on postoperative day 1 and peak values during hospitalization. Furthermore, we assessed creatine kinase and creatinine kinase-myocardial type, as well as safety endpoints.Results A total of 56 patients who received microplegia and 155 patients who received Cardioplexol® were included. The use of the microplegia was associated with significantly lower geometric mean (confidence interval) peak values of high-sensitivity cardiac troponin-T (233 ng/L [194–280 ng/L] vs. 362 ng/L [315–416 ng/L]; p = 0.001), creatinine kinase (539 U/L [458–633 U/L] vs. 719 U/L [645–801 U/L]; p = 0.011), and creatinine kinase-myocardial type (13.8 µg/L [9.6–19.9 µg/L] vs. 21.6 µg/L [18.9–24.6 µg/L]; p = 0.026), and a shorter length of stay on the intensive care unit (1.5 days [1.2–1.8 days] vs. 1.9 days [1.7–2.1 days]; p = 0.011). Major adverse cardiac and cerebrovascular events occurred with roughly equal frequency (1.8 vs. 5.2%; p = 0.331).Conclusions The use of the Basel Microplegia Protocol was associated with lower peak values of high-sensitivity cardiac troponin-T, creatinine kinase, and creatinine kinase-myocardial type and with a shorter length of stay on the intensive care unit, as compared with the use of Cardioplexol® in isolated coronary artery bypass surgery using minimal extracorporeal circulation. PB - Georg Thieme Verlag KG DO - 10.1055/s-0039-1687843 UR - http://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0039-1687843 ER -