Title: Myocardial Protection in Aortic Valve Replacement with Severe Aortic Stenosis: A Comperative Study between Del Nido and HTK Solution

Authors: Kamal Das, Pritam Nandy, Tuhinsubhra Medda, Nripendra kr. Tiwari, Suipta Patra, Dr Bhaskar Das, Dr Rajarshi Basu

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i10.139

Abstract

Both Delnido and HTK Cardioplegia provides excellent myocardial protection and reduces the frequency of cardioplegia administration which allows uninterrupted operation and also reduces ‘x’-clamp timing. Both helps smooth myocardial recovery with post operative minimal inotropic support. But in aortic valve replacement in severe aortic stenosis with hypertrophied myocardium delnido cardioplegia provides poor protection where HTK provides better.

Material and Methods: Twenty adult patients devided into two groups, Group-A (n=10) received delnido cardioplegia and Group-B (n=10) received HTK cardioplegia, underwent aortic valve replacement in severe aortic stenosis with hypertrophid myocardium. In both group same dose of cardioplegia (20ml/kg) was administered through anterograde route.

Results: In group –B  after valve replacement cardiac function was satisfactory with good ejection fraction, no rhythm disturbances occurred, and hemodynamics  was well maintained with minimum inotropic support where  in group-A in 40%cases VT/VF, in 20% case low cardiac output, 60% cases needed  high inotrope with prolonged ventilatory support.

Conclusion: HTK cardioplegia provides better myocardial protection in aortic valve replacement in  severe aortic stenosis with hypertrophied myocardium.

Keywords:  myocardial protection,  del nido cardioplegia, htk cardioplegia, aortic valve surgery.

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Corresponding Author

Kamal Das

MSc in Perfusion Sciences, Chief Perfusionist, Department of Cardiothoracic & Vascular Surgery,

R G Kar Medical College, Kolkata