Iranian Heart Journal

Iranian Heart Journal

Comparison Between Beating and Non–Beating-Heart Pump Approaches Among Patients Undergoing Pulmonary Valvar Surgery: A Randomized Clinical Trial

Document Type : Original Article

Authors
Ali Sadeghpour-Tabaei 1
Zahra Khorrami 2
Akram Ghanbarlou 3
Mohammad Ebrahimi Kalan 4
Mina Daneshmandi 1
Sadegh Miraki 5
1 Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
2 HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran.
3 Taleghani Hospital, Shahid Beheshti University, Tehran, IR Iran.
4 Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA.
5 Department of Emergencies, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, IR Iran.
Abstract
Background: Open-heart surgery is usually done in 2 ways. The first and most common method is done with cardiac arrest after aortic clamping and the perfusion of the cardioplegic solution into the coronary arteries. The second method is the on-pump beating heart, done usually for the right-heart chambers. In this study, we sought to compare these 2 methods concerning cardiac muscle damage, kidney and liver parameters, and clinical outcomes in patients with isolated pulmonary valve repair.
 
Methods: Forty-three patients that underwent cardiopulmonary bypass were randomly assigned to 2 on-pump non-beating (n=20) and beating (n=23) heart groups. We assessed between-group hemodynamics and arterial blood gasses.
 
Results: The operation time was shorter in the beating-heart group than in the non-beating heart group (P=0.003). The ejection fraction (EF) at discharge in the non-beating group was significantly lower than that in the beating-heart group (44.25±6.12 vs 50.00±5.56). Cardiac troponin I and creatine phosphokinase levels showed significant decreases at the preoperative time in both groups; the levels were better in the beating-heart group. No changes were observed in arterial blood gasses before surgery, postoperatively, at intensive care unit admission, and 24 hours after surgery in the 2 groups. The potassium level after the operation was significantly lower in the beating-heart group (4.18 [± 0.85]).
 
Conclusions: The beating-heart surgical procedure conferred a better EF at discharge. Additionally, cardiac troponin I and creatine phosphokinase levels decreased after the preoperative time. (Iranian Heart Journal 2023; 24(1): 22-30)
Keywords
On-pump
Beating and Non-Beating
Heart surgery
Cardiopulmonary bypass
Pulmonary valve repair and replacement
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Iranian Heart Journal
Volume 24, Issue 1
Winter 2023
Pages 22-30