The Effect of Infusion of Dexmedetomidine to the Aortic Root before Aortic Cross-Clamp Removal on the Myocardial Protection in Patients Undergoing Mitral Valve Surgery; A Triple-Blinded Randomized Clinical Trial
نویسندگان
1 Department of Extra-Corporeal Circulation (ECC), Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
2 Department of Cardiovascular Disease, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
3 Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
4 Pediatric and Congenital Cardiology Division, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
5 Department of Extra-Corporeal Circulation (ECC), Razavi Hospital, Imam Reza International University, Mashhad, Iran.
doi
10.30483/rjm.2025.254653.1427چکیده
Background: Myocardial protection during cardiopulmonary bypass is a challenging dilemma. Some protective strategies have been introduced to ameliorate ischemic-reperfusion injury, although no optimal strategy has emerged.Objectives: Herein, we evaluated the effect of aortic root infusion of Dexmedetomidine before cross-clamp removal on myocardial preservation.Methods: This randomized, multicenter, triple-blinded controlled trial enrolled 56 patients who underwent mitral valve surgery. After randomization, the patients were allocated to the case group (Dexmedetomidine infusion in the aortic root before cross-clamp removal) and the control group (isotonic saline). Based on the study goals, Troponin-I and Creatinine kinase-MB were measured as primary outcomes at different time points during the study. Other clinical parameters were also measured as secondary outcomes. Statistical analysis was performed using SPSS software version 26.0 (Chicago, IL, USA). The significance level was considered as P<0.05.Results: A total of 54 patients in the case and control groups were included in the analysis. The main finding of this study was that troponin-I levels at all time points showed statistical differences between the two groups (P=0.001). Also, evaluation of CK-MB levels showed a significant decrease at 1 hour (P=0.001), 12 hours (P=0.001), and 24 hours (P=0.001) after ICU admission, in the case group compared with the control group.Conclusion: This study found that administering a Dexmedetomidine infusion before aortic cross-clamp removal can ameliorate ischemia-reperfusion injury-induced myocardial damage.
