NBCS The only registered drug for blood normothermic cardioplegia - - PowerPoint PPT Presentation

Innovative potassium-based normothermic blood cardioplegic solution

NBCS

The only registered drug for blood normothermic cardioplegia Chernov I., Tarasov D., Melerzanov A., Volgushev V.

Applied as “standard” for all types of cardioplegic surgery

Benefits:

Ø Effective asystole Ø Protection up to 120 minutes or more with a single infusion of 400 ml of the solution Ø Criterion for re-introduction of NBCS – activity of the ventricles of the heart Ø Virtually unlimited aortic cross-clamp time Ø Spontaneous resumption of the cardiac rhythm Ø Ischemic and reperfusion injuries of the heart were not detected Ø In routine practice, there is no need for cardiotonic support in the immediate postoperative period

Ø Over 1000 surgeries Ø Post-registration observational study completed

• n 150 patients

Ø Intraoperative heart failure was not registered Ø The maximum surgery time with a single infusion

• 154 minutes with spontaneous resumption of

the cardiac rhythm without heart failure development and cardiotonic support Clinical approbation

Patients summary

MALE FEMALE

Sex

66 84

MIN MAX

AGE, years

MEDIAN: 60

22 80

MIN MAX

BMI

MEDIAN; 27,7

18 43

150 patients enrolled in the study

Preoperative state & surgery performed

LVEF ≤ 30% MI in anamnesis LV PI aneurysm = 2 / 2 / 1 LVEF 30% … 45% MI in anamnesis LV PI aneurysm = 16 / 7 / 3

LVEF 45% … 55% MI in anamnesis LV PI aneurysm = 31 / 9 / 3 LVEF ≥ 55% MI in anamnesis LV PI aneurysm = 101 / 8 / 2

ACQUIRED HEART DEFECTS CABG PATHOLOGY OF THE AORTA CONGENITAL HEART DISEASE PATHOLOGY OF OTHER VESSELS CARDIOMYOPATHY COMBINED SURGERY

131 51 25 18 12 2 65

28 274 MIN MAX

CPB duration (min)

MEDIAN; 86

17 154 MIN MAX

Cross-clamp duration (min)

MEDIAN; 59

81 53 12 4

Cross-clamp duration (min)

… ≤60 min > 60 … ≤90 min > 90 … ≤120 min … >120 min

90 35 25

CPB duration (min)

… ≤90 min > 90 … ≤120 min … >120 min

Surgery Parameters

100 200 300 400 500 600 700 800 900

134 1 6 1 8 142 4 1 3 1 2 5

volume per operation single dose

Patients, N

Cardioplegic volume

repeated dose

Cardioplegic volume, ml

150 yes no

Cardiac arrest through asystole

136 14 yes no

Spontaneous heart beat recovery

11 139 yes no

Heart rhythm disturbances

1 149 yes no

CPB reconnection

150 yes no

Renal insufficiency

150 yes no

Hepatic failure

Surgery outcome

1 149 yes no

Intraoperative acute heart failure

150 yes no

Intraoperative stroke

2 148 yes no

Intraoperative MI

3 147 yes no

Death

150 yes no

Pulmonary insufficiency

7 143 yes no

Adrenaline > 0.05 mcg/kg/min

Surgery outcome

Blood analysis

Before

• peration

Before

• peration

Main stage End of

• peration

After surgery in the operating room Main stage End of

• peration

After surgery in the operating room Before

• peration

Main stage End of

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After surgery in the operating room Before

• peration

Main stage End of

• peration

After surgery in the operating room

pH Lac (mmol/L K+ (mmol/L Hct (%)

15 820 MIN MAX

Resuscitation time (hrs)

MEDIAN; 22

4 34 MIN MAX

Rehabilitation time (days)

MEDIAN; 7

99 26 9 16

Resuscitation time distribution

… ≤ 24 hours > 24 … ≤ 48 hours > 48 … ≤ 72 hours … > 72 hours

78 55 17

Rehabilitation time distribution

… ≤ 7 days > 7 … ≤ 12 days … > 12 days

Recovery

Cooperation

We welcome you to visit out international clinical research center and participate in surgeries to estimate the solution efficacy!

Alexander V Melerzanov MD, PhD, Dean

• f

Biological and Medical Physics MIPT Mail: Melerzanov.av@mipt.ru Phone +79151555550

Thank you for your attention!