Comparison of St. Thomas and Dr. Soetomo Hospital cardioplegia in coronary artery bypass grafting surgery

Background: Temporary cardiac arrest using cardioplegia is a critical step during coronary artery bypass graft (CABG) surgery to protect the heart from ischemia. Due to limited availability, Dr. Soetomo Hospital in Surabaya developed an alternative mixture to replace the standard St. Thomas cardioplegia. This study aimed to compare the effectiveness of St. Thomas and Dr. Soetomo Hospital cardioplegia in CABG surgery in terms of achieving cardioplegic arrest, plasma potassium balance, and preventing arrhythmias. Methods: A retrospective cohort study was conducted among adult patients undergoing CABG who were administered either St. Thomas or Dr. Soetomo Hospital cardioplegia during November 2019 and May 2020. The time to achieve cardioplegic arrest, plasma potassium levels, and ventricular fibrillation or tachycardia incidence were recorded and analyzed. Results: Out of 74 patients, 37 each received St. Thomas cardioplegia and Dr. Soetomo Hospital cardioplegia, with no significant differences in demographic characteristics between the two groups (p>0.05). The results revealed that both types of cardioplegia were equally effective in maintaining plasma potassium balance and preventing life-threatening arrhythmias. However, Dr. Soetomo Hospital cardioplegia achieved cardioplegic arrest significantly (p<0.05) faster than St. Thomas cardioplegia. Conclusion: Dr. Soetomo Hospital’s cardioplegia demonstrated increased efficacy in achieving faster cardiac arrest, which has significant implications for optimizing surgical efficiency and reducing myocardial damage during CABG.