Impact of enhanced myocardial protection protocols on perioperative outcomes in complex valve surgery

The study aimed to evaluate whether enhanced myocardial protection protocols reduce postoperative myocardial injury, improve hemodynamic stability, and shorten recovery times in patients undergoing complex valve surgery compared with conventional myocardial protection strategies.A prospective observational cohort study was conducted involving 168 adults undergoing multivalve or redo valve procedures.Participants received either enhanced myocardial protection using modified cardioplegia, targeted myocardial cooling, perfusion adjuncts, and real-time metabolic monitoring or standard protection.Comprehensive perioperative data, including myocardial biomarkers, hemodynamic parameters, complication rates, ventilation duration, and ICU and hospital length of stay, were collected and analyzed using appropriate statistical methods.Enhanced myocardial protection significantly reduced postoperative myocardial injury, reflected by lower 24-hour troponin and CK-MB levels.Patients in the enhanced group demonstrated better intraoperative metabolic profiles, fewer arrhythmias, reduced inotropic requirements, and improved hemodynamic stability.These physiological advantages translated into shorter mechanical ventilation times, reduced ICU stays, and earlier overall discharge compared with conventional protection.A lower incidence of postoperative low-output syndrome and fewer complications further supported the superiority of enhanced protection.Enhanced myocardial protection protocols provide substantial perioperative benefits in complex valve surgery by attenuating ischemia-reperfusion injury, stabilizing hemodynamics, and accelerating postoperative recovery.These findings support the integration of enhanced protection strategies into routine surgical practice to optimize outcomes, particularly in high-risk patient populations.