For patients randomized to lactated Ringer's solution (study group), lactated Ringer's solution is used as a base solution for del Nido cardioplegia.

For patients randomized to PlasmaLyte-A (control group), PlasmaLyte-A (Baxter Healthcare Corporation, Deerfield, IL, USA) is used as a base solution for del Nido cardioplegia.

Myocardial Injury

Comparison of Lactated Ringer's Solution and PlasmaLyte-A as a Base Solution for Del Nido Cardioplegia

Lactated Ringer

Ramathibodi Hospital

Ventricular fibrillation after aortic cross-clamp removal required defibrillation

Difference between pre-op and post-op LVEF. LVEF was assessed by transesophageal echocardiography before surgery and at the end of operation.

Length of inotropic or vasopressor support in intensive care unit (hour)

Requirement for intra-aortic balloon pump (IABP) support

Operative mortality includes both (1) all deaths occurring during the hospitalization in which the operation wasperformed, even if after 30 days; and (2) those deaths occurring after discharge from the hospital, but within 30 days ofthe procedure.

Postoperative stroke (i.e., any confirmed neurological deficit of abrupt onset caused by a disturbance in blood supply tothe brain that did not resolve within 24 hours.

Acute or worsening renal failure resulting in one or more of the following:1.Increase of serum creatinine to ≥ 4.0 with an increase of at least 0.5mg/dl or 3x most recent preoperativecreatinine level.2.A new requirement for dialysis postoperatively.

Prolonged post-operative pulmonary ventilation > 24.0 hours. The hours of postoperative ventilation time include ORexit until extubation, plus any additional hours following reintubation.

Deep sternal wound infection or mediastinitis (according to CDC definition) diagnosed within 30 days of the operationor any time during the hospitalization for the surgery

Reoperation for bleeding/tamponade, valvular dysfunction, graft occlusion, other cardiac reason, or non-cardiac reason

A composite endpoint defined as any of the outcomes listed above, including; Operative mortality, Permanent Stroke,Renal Failure, Prolonged Ventilation > 24 hours, Deep sternal wound infection, Reoperation for any reason.

Mahidol University

Blood cardioplegia administration without roller pump

Blood cardioplegia administration with roller pump

Coronary Disease

In the no pump group blood cardioplegia was delivered using the arterial line pressure, created by the arterial centrifugal pump of the cardiopulmonary bypass system. Blood cardioplegia flow depended on the difference between arterial line pressure and aortic root pressure.

No pump

In the pump group blood cardioplegia was delivered using a roller pump. The blood cardioplegia flow was given at 200 mL/min.

Pump

The following biomarkers were analysed: TnT-hs, H-FABP, NT-pro-BNP and CRP.

Blood sample collection: after induction of anaesthesia (T0)

Blood sample collection: after arrival at the ICU (T1)

Blood sample collection: 4 hours in ICU (T2)

Blood sample collection: the first postoperative day (T3)

St. Antonius Hospital

Administration of Warm Blood Cardioplegia With or Without Roller Pump

Administration of Warm Blood Cardioplegia With or Without Roller Pump; a Randomized Controlled Trial.

Mizja M. Faber

Atenolol tablet and Aliskiren 150mg or 300mg tablet by mouth per day for 6month

Atenolol tablet(Negative controls, Open-label)

Atenolol tablet and Aliskiren 150mg or 300mg tablet by mouth per day for 6month
Aliskiren
Atenolol

Atenolol & Aliskiren

Atenolol tablet(Negative controls, Open-label)
Atenolol

Atenolol

Total

Sex: Female, Male

Analyses of the MRIs were performed using commercial software (Argus version 4.02, Siemens Medical Systems, Germany) by experienced observers who were blinded to patient information. To measure central aortic distensibility, the systolic and diastolic cross-sectional areas were measured by manual contouring of the aorta through the cardiac cycle on the cine image. Distensibility at the four regions was calculated as the mean of values obtained from the following equation: Distensibility = (Amax - Amin)/[Amin × (Pmax - Pmin)](10-3mm/Hg), where Amax is the maximal (systolic) aortic area, Amin is the minimal (diastolic) aortic area, Pmax is the systolic blood pressure (SBP), and Pmin is the diastolic blood pressure (DBP). Central aortic blood pressure measured non-invasively by SphygmoCor was used for systolic and diastolic blood pressure.

Central Aortic Distensibility by MRI

Aortic PWV was measured according to the well-validated method using MRI 19. From the velocity-encoded MRIs, aortic contours were automatically detected and manually adjusted in each slice area throughout the cardiac cycle. The transit time between the flow curves of each region of the aorta was determined from the midpoint of the systolic up-slope on the flow versus time curve 26-28. The up-slopes were identified by drawing a line between the points of 40% and 60% maximum velocity on the waveform. The distance between each aortic level was measured on black blood images using a curved line along the center of the aorta. Based on these data, the regional PWV was calculated as the ratio of the distance between levels and the time differences between the arrival of the pulse wave at each level. The PWV was measured at two regions: the proximal aorta (proximal PWV between level 1 and level 2) and the entire aorta (PWV-total between level 1 and level 4).

Atenolol and Aliskiren

Atenolol tablet(Negative controls, Open-label)
Control group baseline 24 Weeks Central PWV (m/s)(26) by MRI regional PWV A (level 1-2) 3.8 (1.7) 3.6 (1.23) PWV-total (level 1-4) 5.0 (1.03) 4.9 (1.24)

Central Aortic PWV(Pulsed Wave Velocity)

Overall Study

Prof Duk-Kyung Kim

Atenolol tablet and Aliskiren 150mg or 300mg tablet by mouth per day for 6month
Treatment (n=14) Overall rate of adverse events 12 (85.7%) moderate to severe cases 0 generalized symptoms 8 (57.1%) gastrointestinal symptoms 4 (28.6%) lung problems 0 cardiovascular symptoms 3 (21.4%) central nervous system symptoms 5 (35.7%) Eye, nose, throat symptoms 4 (28.6%) gynecologic problems 1 (7.1%) problems of extremities 1 (7.1%)

Atenolol tablet(Negative controls, Open-label)
Control (n=14) Overall rate of adverse events 10 (71.4%) moderate to severe cases 2 (14.3%) generalized symptoms 4 (28.6%) gastrointestinal symptoms 3 (21.4%) lung problems 1 (7.1%) cardiovascular symptoms 0 central nervous system symptoms 1 (7.1%) Eye, nose, throat symptoms 1 (7.1%) gynecologic problems 1 (7.1%) problems of extremities 2 (14.3%)

Marfan Syndrome

Aliskiren

Samsung Medical Center

Comparison of Aliskiren vs Negative Controls on Aortic Stiffness in Patients With MFS

Comparison Study of the Effect of Aliskiren Versus Negative Controls on Aortic Stiffness in Patients With Marfan Syndrome Under Treatment With Atenolol

aortic valve insufficiency/potassium

Comparison of Lactated Ringer's Solution and PlasmaLyte-A as a Base Solution for Del Nido Cardioplegia

Administration of Warm Blood Cardioplegia With or Without Roller Pump

Comparison of Aliskiren vs Negative Controls on Aortic Stiffness in Patients With MFS

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