Study strengths and limitations
Our study has several strengths. Firstly, it was the first randomized, double-blind, placebo-controlled study in this area. Secondly, our cohort included high-risk cohort of patients undergoing double or triple valve surgery. Thirdly, patients were followed up for 30 days for vital status assessment.One limitation of current study was that, due to pilot design of the study, no power calculation was performed. Another limitation of the study was that sevoflurane, which has cardioprotective properties, was used as a main anesthetic agent. This might have influenced the results of the study.