{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:29:58Z","timestamp":1765888198067},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,9,18]],"date-time":"2019-09-18T00:00:00Z","timestamp":1568764800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p \/><jats:sec><jats:title>OBJECTIVES<\/jats:title><jats:p>The optimal myocardial protective solution in the neonatal arterial switch operation remains controversial. The aim of this study was to demonstrate that Bretschneider\u2019s histidine\u2013tryptophan\u2013ketoglutarate crystalloid solution (Custodiol) offers protection at least similar to that of cold blood cardioplegia.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Patients who underwent the neonatal arterial switch operation with Custodiol between January 2016 and December 2018 (n\u2009=\u200923) were compared with an historical cohort from August 2010 to December 2015 in which cold blood cardioplegia was used (n\u2009=\u200941). A linear mixed-effect model for repeated measures was performed to test the recovery of myocardial function based on inotropic and vasoactive inotropic scores, cardiac enzyme release and left ventricular ejection fraction.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Patients in the cold blood cardioplegia group had higher inotropic scores in the first 24\u2009h (0\u2009h, P\u2009=\u20090.001 and 24\u2009h, P\u2009=\u20090.006) and higher vasoactive inotropic scores in the first 72\u2009h (0\u2009h, 24\u2009h and 48\u2009h, P\u2009&amp;lt;\u20090.001; 72\u2009h, P\u2009=\u20090.012). Cardiac troponin-I concentrations were higher in the cold blood cardioplegia group at postoperative hours 1\u201372 (1\u2009h, 6\u2009h, 12\u2009h and 24\u2009h, P\u2009&amp;lt;\u20090.001; 48\u2009h, P\u2009=\u20090.001 and 72\u2009h, P\u2009=\u20090.003). Creatinine-kinase-MB concentrations were higher in the cold blood cardioplegia group at postoperative hours 1\u201324 (1\u2009h, 6\u2009h and 12\u2009h, P\u2009&amp;lt;\u20090.001; 24\u2009h, P\u2009=\u20090.042). The left ventricular ejection fraction was higher in the Custodiol group just after the operation (P\u2009=\u20090.005), at 24\u2009h (P\u2009=\u20090.001) and on the first day without inotropic support (P\u2009=\u20090.011).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Neonatal myocardium protected with Custodiol during the arterial switch operation presented optimal ventricular function recovery with less inotropic support and less myocardial damage compared with cold blood cardioplegia.<\/jats:p><\/jats:sec>","DOI":"10.1093\/icvts\/ivz216","type":"journal-article","created":{"date-parts":[[2019,8,19]],"date-time":"2019-08-19T19:23:32Z","timestamp":1566242612000},"page":"136-143","source":"Crossref","is-referenced-by-count":6,"title":["Myocardial protection in the arterial switch operation: Custodiol versus cold blood cardioplegia"],"prefix":"10.1093","volume":"30","author":[{"given":"Joaqu\u00edn","family":"P\u00e9rez-Andreu","sequence":"first","affiliation":[{"name":"Paediatric Cardiac Surgery Department, Vall d\u00b4Hebron University Hospital, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joaqu\u00edn","family":"Fern\u00e1ndez-Doblas","sequence":"additional","affiliation":[{"name":"Paediatric Cardiac Surgery Department, Vall d\u00b4Hebron University Hospital, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Augusto","family":"Sao Avil\u00e9s","sequence":"additional","affiliation":[{"name":"Biostatistics, Cardiology Department, Vall d\u00b4Hebron University Hospital, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa","family":"de la Torre Garc\u00eda","sequence":"additional","affiliation":[{"name":"Paediatric Anaesthesia Department, Vall d\u00b4Hebron University Hospital, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ferr\u00e1n","family":"Roses Noguer","sequence":"additional","affiliation":[{"name":"Paediatric Cardiology Department, Vall d\u00b4Hebron University Hospital, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ra\u00fal F","family":"Abella","sequence":"additional","affiliation":[{"name":"Paediatric Cardiac Surgery Department, Vall d\u00b4Hebron University Hospital, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,9,17]]},"reference":[{"key":"2019122407374900200_ivz216-B1","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1097\/PCC.0000000000001533","article-title":"Prevention of low cardiac output syndrome after pediatric cardiac surgery: a double-blind randomized clinical pilot study comparing dobutamine and milrinone","volume":"19","author":"Cavigelli-Brunner","year":"2018","journal-title":"Pediatr Crit Care Med"},{"key":"2019122407374900200_ivz216-B2","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1177\/0267659112453754","article-title":"Is there any difference between blood and crystalloid cardioplegia for myocardial protection during cardiac surgery? 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