Evidence mapPaperPMID 40468334Full record

ArticleJournal of cardiothoracic surgery2025

Blood cardioplegia or custodiol for myocardial protection during valvular or aortic surgery: a propensity score adjusted comparison.

Manuel Carnero-Alcazar, Lourdes Montero-Cruces, Rosa Beltrao-Sial, Raquel Blazquez, Ivan Nuñez-Gil, Daniel Perez-Camargo, Javier Cobiella-Carnicer, Juan Miguel Miranda Torron, Maria Alejandra Giraldo, Luis Maroto Castellanos

Erratum issuedAbstract readComparative Study
In one paragraph

Article in Journal of cardiothoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Manuel Carnero-AlcazarDepartment of Cardiac Surgery, Hospital Clínico San Carlos, Madrid, Spain. mcarneroalcazar@gmail.com.
Lourdes Montero-CrucesDepartment of Cardiac Surgery, Hospital Clínico San Carlos, Madrid, Spain.
Rosa Beltrao-SialDepartment of Anesthesiology, Hospital Clínico San Carlos, Madrid, Spain.
Raquel BlazquezHospital Clínico San Carlos, Madrid, Spain.
Ivan Nuñez-GilDepartment of Cardac Surgery, Hospital de Torrejón, Torrejón de Ardoz, Spain.
Daniel Perez-CamargoDepartment of Cardiac Surgery, Hospital Clínico San Carlos, Madrid, Spain.
Javier Cobiella-CarnicerDepartment of Cardiac Surgery, Hospital Clínico San Carlos, Madrid, Spain.
Juan Miguel Miranda TorronDepartment of Cardiac Surgery, Hospital Clínico San Carlos, Madrid, Spain.
Maria Alejandra GiraldoDepartment of Cardiac Surgery, Hospital Clínico San Carlos, Madrid, Spain.
Luis Maroto CastellanosDepartment of Cardiac Surgery, Hospital Clínico San Carlos, Madrid, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is no solid evidence on the clinical benefits of blood cardioplegia or Custodiol™ in procedures other than coronary artery bypass grafting. We aimed to compare mortality and the risk of major cardiovascular events in patients undergoing valve or aortic surgery.

methodsThis retrospective single-center study included patients who underwent valve or ascending aortic surgery between 2016 and 2024. The sample was divided based on the type of cardioplegia for myocardial protection: Custodiol™ or blood cardioplegia. The comparison of outcomes between the two groups was adjusted using propensity score.

results2909 patients were included, with 1426 (49%) receiving Custodiol™. In a propensity score-matched analysis that included 930 pairs, we observed higher perioperative mortality in the blood cardioplegia group (5.3% vs. 2.9%, p = 0.014) and worse long-term survival (p = 0.004). In an IPTW analysis, we confirmed significant differences in favor of Custodiol™ for early mortality (-2.2%, 95% CI -4; -0.4), long-term mortality (2.6 years, 95% CI 2.1; 3.2), and renal failure (-4.7%, 95% CI -7.9; -1.6), and low cardiac output syndrome requiring mechanical circulatory support (-2.2%, 95% CI -3.6;-0.9), but a higher siks of postoperative denovo atrial fibrillation (6.8%, 95% CI 2.5;11).

conclusionsIn this retrospective study including patients undergoing on-pump valve and aortic surgery, Custodiol™ compared to blood cardioplegia was associated with lower short- and medium-term mortality, although no robust evidence was found for differences in other clinical events.

Indexed as

AortaAortic ValveCardioplegic SolutionsHeart Arrest, InducedPotassium ChloridePropensity ScoreAgedFemaleHumansMaleMiddle AgedProcaineRetrospective StudiesCardioplegic SolutionsPotassium ChlorideProcaineAortic surgeryCardioplegiaMyocardial protectionValve surgery

Identifiers

PMID40468334
PMCPMC12135263

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.