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
Clinical approbation Ø Over 1000 surgeries Ø Post-registration observational study completed on 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
Patients summary Sex 84 66 150 patients enrolled in the study MALE FEMALE BMI AGE, years 43 80 MEDIAN: 60 MEDIAN; 27,7 18 22 MIN MAX MIN MAX
Preoperative state & surgery performed 131 ACQUIRED HEART DEFECTS LVEF ≤ 30% = 2 MI in anamnesis / 2 51 CABG LV PI aneurysm / 1 25 PATHOLOGY OF THE AORTA LVEF 30% … 45% = 16 MI in anamnesis / 7 18 CONGENITAL HEART DISEASE LV PI aneurysm / 3 12 PATHOLOGY OF OTHER VESSELS LVEF 45% … 55% = 31 2 CARDIOMYOPATHY MI in anamnesis / 9 LV PI aneurysm / 3 65 COMBINED SURGERY LVEF ≥ 55% = 101 MI in anamnesis / 8 LV PI aneurysm / 2
Surgery Parameters Cross-clamp duration (min) CPB duration (min) 274 154 MEDIAN; 86 MEDIAN; 59 28 17 MIN MAX MIN MAX CPB duration (min) Cross-clamp duration (min) 90 81 53 35 25 12 4 … ≤90 min > 90 … ≤120 min … >120 min … ≤60 min > 60 … ≤90 min > 90 … ≤120 min … >120 min
Cardioplegic volume 900 800 700 Cardioplegic volume, ml 600 500 400 300 200 100 0 Patients, N 1 2 5 134 1 6 1 8 142 4 1 3 volume per operation single dose repeated dose
Surgery outcome Cardiac arrest Spontaneous Heart rhythm through asystole heart beat disturbances recovery 150 136 139 14 11 0 yes no yes no yes no CPB Renal Hepatic failure reconnection insufficiency 150 149 150 0 0 1 yes no yes no yes no
Surgery outcome Intraoperative MI Intraoperative Intraoperative stroke acute heart 148 failure 150 149 2 1 0 yes no yes no yes no Pulmonary Adrenaline Death insufficiency > 0.05 mcg/kg/min 150 147 143 0 3 7 yes no yes no yes no
Blood analysis K+ (mmol/L pH Before Main End of After surgery in Before Main End of After surgery in operation stage operation the operating operation stage operation the operating room room Lac (mmol/L Hct (%) Before Main End of After surgery in Before Main End of After surgery in operation stage operation the operating operation stage operation the operating room room
Recovery Rehabilitation time (days) Resuscitation time (hrs) 34 820 MEDIAN; 7 4 MEDIAN; 22 15 MIN MAX MIN MAX Rehabilitation time distribution Resuscitation time distribution 78 99 55 17 26 16 9 … ≤ 7 days > 7 … ≤ 12 days … > 12 days … ≤ 24 hours > 24 … ≤ 48 hours > 48 … ≤ 72 hours … > 72 hours
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 of Biological and Medical Physics MIPT Mail: Melerzanov.av@mipt.ru Phone +79151555550 Thank you for your attention!
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