Javad Ramezani; Hamid Hoseinikhah; Kayhan Mizani; Mohamadreza Akbari; Mahsa Moallemi; Maryam Argi; Aliasghar Moeinipour
Abstract
Controlled intraoperative cardioplegia is indispensable to pediatric cardiac surgery procedures. Several preservation techniques have been proposed for such purposes, with varying application by different surgeons. The custodiol cardioplegia is a recent approach that is considered to be a safe and effective ...
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Controlled intraoperative cardioplegia is indispensable to pediatric cardiac surgery procedures. Several preservation techniques have been proposed for such purposes, with varying application by different surgeons. The custodiol cardioplegia is a recent approach that is considered to be a safe and effective cardiac protector. This narrative review was conducted via searching in four databases, including PubMed, Scopus, Embase, and ScienceDirect. The studies focused on the efficacy and safety of custodiol cardioplegia reviewed, especially in pediatric cardiac surgeries and relevant procedures. In total, 21 articles were eligible, and the findings highlighted the controversies regarding the use of various cardioplegic solutions and the variability of their application by surgeons. However, data were inadequate regarding the optimal cardioplegic solutions in this regard. Some of the studies performed on adults suggested that custodiol cardioplegia may be equivalent to conventional blood cardioplegia. Most of the reviewed articles showed a consensus on the safety and efficacy of custodiol cardioplegia in adult and pediatric cardiac surgeries. It is believed that custodiol procedures are not only easily delivered, but they are also convenient and less time-consuming and provide long-lasting motion and bloodless fields for the surgeon to perform the operation. Therefore, use of custodiol cardioplegia has been reported to be safe, effective, and cost-efficient compared to conventional cardioplegic solutions. However, different findings have also been denoted in some of the studies in this regard, implying the equal effectiveness of these techniques.
Aliasghar Moeinipour; Mohamad Abbassi Teshnizi; Babak Manafi; Hadi Yavari; Yasamin Moeinipour; Hamid Hoseinikhah
Abstract
Herbal medicine is usually safe and popular in Iranian communities. Peppermint herbal products may interact with warfarin, which is an essential lifelong drug used in patients with prosthetic heart valves. Herein, we report a case of possible interaction between warfarin and peppermint herbal tea.We ...
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Herbal medicine is usually safe and popular in Iranian communities. Peppermint herbal products may interact with warfarin, which is an essential lifelong drug used in patients with prosthetic heart valves. Herein, we report a case of possible interaction between warfarin and peppermint herbal tea.We described a 68-year-old woman who was on warfarin treatment due to bileaflet mechanical aortic valve, and mitral valve replacement presented with severe dyspnea in the setting of large obstructive prosthetic mitral valve thrombosis diagnosed by echocardiography. Therefore, cardiac surgery was conducted in the emergent setting. Warfarin was started the day after the procedure. She developed melena with a volatile and elevated international normalized ratio (INR) of 4.8 and prothrombin time > 30 s on the 7th post-operation day. She reported no changes in drug or dietary habits except for drinking high amounts of peppermint tea the day before. After the discontinuation of warfarin and medical consultation for gastrointestinal bleeding, the INR level decreased to 1.8 within two days.Consumption of peppermint herbal products are usually safe; however, caution should be taken with patients under warfarin treatment. Full disclosure for patients on anticoagulant treatment is necessary before discharge and during clinical follow-up