• Bmc Cardiovasc Disor · May 2020

    Comparative Study Observational Study

    Transitioning to Del Nido cardioplegia for all-comers: the next switching gear?

    • Mohamed Marzouk, Valerie Lafreniere-Bessi, Stephanie Dionne, Serge Simard, Christian Pigeon, François Dagenais, Niv Ad, and Frederic Jacques.
    • Service of Cardiac Surgery, Institut universitaire de cardiologie et de pneumologie de Québec-IUCPQ, Université Laval, Quebec City, QC, G1V 4G5, Canada.
    • Bmc Cardiovasc Disor. 2020 May 8; 20 (1): 215.

    BackgroundExclusive use of Del Nido cardioplegia administration in all adult patients undergoing cardiac surgery has been studied for operative, postoperative and myocardial protection outcomes.MethodsFrom November 2016 to October 2017, Del Nido cardioplegia was used in 131 consecutive patients (DN group). Using a propensity score, DN group was compared to 251 patients having received intermittent cold blood cardioplegia (CB group).ResultsPreoperative characteristics were similar in DN and CB groups. Operative outcomes were statistically different (p < 0.0001): cardiopulmonary bypass (CPB) time (DN 105.9 ± 46.5, CB 131.2 ± 38.8); aortic cross-clamp time (DN 80.8 ± 35.5, CB 102.2 ± 31.3); operative time (DN 203.1 ± 65.0, CB 241.5 ± 54.7); total cardioplegia volume (DN 1328 ± 879, CB 3773 ± 1226); and peak glycemia on CPB (DN 8.2 ± 2.3, CB 9.0 ± 1.8). No statistical differences were noted in intensive care unit stay, hospital stay and hospital death. Myocardial protection outcomes were similar: discharge left ventricular ejection fraction (DN 52 ± 11, CB 51 ± 10); Troponin levels at the end of the surgery (DN 871 ± 1623, CB 1958 ± 854), day 1 (DN 853 ± 1139, CB 993 ± 8234) and day 4 (DN 442 ± 540, CB 463 ± 317).ConclusionDel Nido cardioplegia use in all adult cardiac surgeries is associated with improved surgical efficiency. The design of larger trials including adults combined cardiac procedures and emergencies is needed.

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