Is Hot-shot Cardioplegia Necessary in Cardiac Surgery with Cardiopulmonary Bypass?

Background: Many solutions and techniques have been developed to protect the myocardium during cardiac surgery with cardiopulmonary bypass. Hot-shot cardioplegia is given during removal of the aortic cross-clamp, i.e. during restart of the heart, but its necessity and additional benefit are controversial. The aim of this retrospective study was to evaluate the necessity and/or extra benefit of hot-shot cardioplegia administration and early clinical outcomes in patients undergoing cardiac surgery with cardiopulmonary bypass. Methods: This retrospective study included a total of 686 patients who underwent cardiac surgery with cardiopulmonary bypass. The study groups were defined as patients without hot-shot cardioplegia (Group 1) and patients with hot-shot cardioplegia (Group 2). Descriptive data and early clinical outcomes of the groups were compared. Results: Demographic and descriptive data of the patients included in the study were similar in both groups (p > 0.05). There was no difference between the groups in potassium levels, Creatine Kinase-Myocardial Bound and Cardiac Troponin T levels indicative of myocardial necrosis, and Carbohydrate Reactive Protein levels indicative of inflammation (p > 0.05). In addition, there was no difference in the need for intracardiac defibrillation, inotrope requirement during cardiopulmonary bypass weaning, intra-aortic balloon pump requirement, early postoperative arrhythmia, atrial fibrillation, duration of mechanical ventilation, intensive care unit stay, hospital stay and mortality rates (p > 0.05). Conclusion: In conclusion, it is thought that hot-shot cardioplegia application does not provide any additional benefit in preventing myocardial damage or in postoperative clinical and metabolic markers in cardiac surgery performed with cardiopulmonary bypass.