arch curr med res Archives of Current Medical Research 2717-9788 14 Mart Tıbbiyeliler Derneği 10.47482/acmr.1631396 Cardiovascular Surgery Kalp ve Damar Cerrahisi Is Hot-shot Cardioplegia Necessary in Cardiac Surgery with Cardiopulmonary Bypass? Kardiyopulmoner Bypass Eşliğinde Yapılan Kalp Cerrahisinde Hot-shot Kardiyoplejisi Gerekli midir? https://orcid.org/0000-0003-0320-4239 Amaç Bişar HARRAN UNIVERSITY, FACULTY OF HEALTH SCIENCES https://orcid.org/0000-0003-2418-5823 Engin Mesut SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, BURSA YÜKSEK İHTİSAS SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ https://orcid.org/0000-0003-1821-1706 Abanoz Mustafa UNIVERSITY OF HEALTH SCIENCES, ŞANLIURFA MEHMET AKİF İNAN HEALTH RESEARCH CENTER 09 28 2025 6 3 192 199 02 01 2025 04 11 2025 Copyright © 2020, Archives of Current Medical Research 2020 Archives of Current Medical Research

Background: Many solutions and techniques have been developed to protect the myocardium during cardiac surgery with cardiopulmonary bypass. Hot-shot cardioplegia is given during removal of the aortic cross-clamp, i.e. during restart of the heart, but its necessity and additional benefit are controversial. The aim of this retrospective study was to evaluate the necessity and/or extra benefit of hot-shot cardioplegia administration and early clinical outcomes in patients undergoing cardiac surgery with cardiopulmonary bypass.Methods: This retrospective study included a total of 686 patients who underwent cardiac surgery with cardiopulmonary bypass. The study groups were defined as patients without hot-shot cardioplegia (Group 1) and patients with hot-shot cardioplegia (Group 2). Descriptive data and early clinical outcomes of the groups were compared.Results: Demographic and descriptive data of the patients included in the study were similar in both groups (p > 0.05). There was no difference between the groups in potassium levels, Creatine Kinase-Myocardial Bound and Cardiac Troponin T levels indicative of myocardial necrosis, and Carbohydrate Reactive Protein levels indicative of inflammation (p > 0.05). In addition, there was no difference in the need for intracardiac defibrillation, inotrope requirement during cardiopulmonary bypass weaning, intra-aortic balloon pump requirement, early postoperative arrhythmia, atrial fibrillation, duration of mechanical ventilation, intensive care unit stay, hospital stay and mortality rates (p > 0.05).Conclusion: In conclusion, it is thought that hot-shot cardioplegia application does not provide any additional benefit in preventing myocardial damage or in postoperative clinical and metabolic markers in cardiac surgery performed with cardiopulmonary bypass.

Giriş: KPB eşliğinde yapılan kalp cerrahisinde miyokardı korumak için çok sayıda solüsyon ve teknik tanıtılmıştır. Hot-shot kardiyoplejisi de aortik kross klembin kaldırılması sırasında yani kalbin yeniden çalıştırılması sırasında verilmekle beraber, gerekliliği ve ekstra fayda sağlama konusu tartışmalıdır. Bu retrospektif çalışmada KPB eşliğinde kardiyak cerrahi uygulanmış hastalarda hot-shot kardiyopleji uygulamasının gerekliliği ve/veya ekstra fayda sağlayıp sağlamadığı ve erken dönem klinik sonuçlarının değerlendirilmesi amaçlanmaktadır.Yöntem: Bu retrospektif çalışmaya KPB eşliğinde kardiyak cerrahi uygulanan toplam 686 hasta verisi dahil edildi. Çalışma grupları hot-shot kardiyoplejisi kullanılmayan (Grup 1) ve hot shot kardiyoplejisi kullanılan hastalar (Grup 2) olarak belirlendi. Grupların tanımlayıcı verileri ve erken dönem klinik sonuçları karşılaştırıldı.Bulgular: Çalışmaya dahil edilen hastaların demografik ve tanımlayıcı verileri her iki grupta da benzerdi (p > 0.05). Grupların potasyum düzeyi, miyokardiyal nekroz göstergesi olan CK-MB ve CTnT düzeyleri ve inflamasyon göstergesi olan CRP düzeyleri arasında fark yoktu (p > 0.05). Ayrıca intrakardiyak defibrilasyon ihtiyacı, KPB weaning sırasındaki inotrop ihtiyacı, IABP ihtiyacı, erken dönem postoperatif aritmi, AF, mekanik ventilasyon süresi, ICU kalış süresi, hastanede kalış süreleri ve mortalite oranları arasında fark gözlenmedi (p > 0.05).Sonuç: Sonuç olarak hot-shot kardiyopleji uygulaması kardiyopulmoner bypass eşliğinde yapılan kalp cerrahisinde miyokardiyal hasarı önlemede veya postoperatif klinik ve metabolik belirteçlerde herhangi bir ekstra fayda sağlamadığı düşünülmektedir.

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