Abstract
Introduction: Del Nido (DN) cardioplegia was invented specially for pediatric cardiac surgery in the 1990s and has longer ischaemic time (less redosing) than ST Thomas cardioplegia (ST).
Aim of Study: To evaluate the safety/efficacy of DN over ST for adult cardiac surgery.
Materials and Methods: The study was conducted among 100 adult patients who underwent CABG/MVR/DVR/AVR. Patients were divided in 2 groups: group 1- who received DN cardioplegia (n=50) and group 2- who received ST cardioplegia (n=50). Cross clamp time (X clamp time), cardiopulmonary bypass time (CPB time), ionotropic support and post cross clamp defibrillation rates were analysed.
Results: The aortic cross clamp and bypass times were shorter with DN than ST (91.94±34.16 vs 106.44±32.63 and 126.26±37.50 vs 139.84±37.84, p value <0.05 respectively). ST group needed higher ionotropic support than DN group (14.62±3.83 vs 11.42±2.84, p value< 0.05). DN group showed significant reduction in Post X clamp defibrillation rate than ST group (5 vs 15, p value<0.05).
Conclusion: DN reduces X clamp and CPB time over ST , and less ionotropic support and post X clamp removal defibrillation is required when using DN in adult cardiac surgery.
Keywords: Del nido, ST Thomas, cardioplegia, adult cardiac surgery.
References
- Matte GS, del Nido PJ. History and use of del Nido cardioplegia solution at Boston Children’s Hospital. JECT 2012; 44: 98-103.
- Charette K, Gerrah R, Quaegebeur J et al.Single dose myocardial protection technique utilizing del Nido cardioplegia solution during congenital heart surgery procedures. Perfusion 2012; 27: 98-103.
- Gaies M. G. Howard E.J. Robert E.N. et al. Vasoactive-Inotropic Score (VIS) is Associated with Outcome After Infant Cardiac Surgery: An Analysis from the Pediatric Cardiac Critical Care Consortium (PC4) and Virtual PICU System Registries. Pediatric Critical Care Medicine: 15(6), 529–537.
- Shiroishi M. Myocardial protection. The rebirth of potassium-based cardioplegia. Tex Heart Inst J. 1999;26:71–86.
- Turkoz R. Myocardial protection in pediatric cardiac surgery. Artif Organs. 2013;37:16–20.
- Kotani Y. Tweddel J. Gruber P. et al. Current cardioplegia practice in pediatric cardiac surgery: A North American multiinstitutional survey. Ann Thorac Surg. 2013;96:923–9.
- Smigla G. Jaquiss R. Walczak R. et al. Assessing the safety of del Nido cardioplegia solution in adult congenital cases. Perfusion 2014; 29: 554-558.
- Sorabella RA . Akashi H. Yerebakan H. et al. Myocardial protection using del Nido cardioplegia solution in adult reoperative aortic valve surgery. J Card Surg 2014; 29: 445-449.
- Yerebakan H . Sorabella RA. Najjar M. et al. Del Nido cardioplegia can be safely administered in high-risk coronary artery bypass grafting surgery after acute myocardial infarction: a propensity matched comparison. J Cardiothorac Surg 2014; 9: 141.
- Mick S. Robich M. Houghtaling P. et al. del Nido versus Buckberg cardioplegia in adult isolated valve surgery. J Thorac Cardiovasc Surg. 2015;149:626–34.
- O’Brien JD . Howlett SE. Burton HJ. et. al. Pediatric cardioplegia strategy results in enhanced calcium metabolism and lower serum troponin T. Ann Thorac Surg 2009; 87: 1517-1523.
- Buel ST. Striker CW. O’Brien JE. et. al. Del Nido versus St. Thomas Cardioplegia Solutions:A Single-Center Retrospective Analysis of Post Cross-Clamp Defibrillation Rates. The Journal of Extra Corporeal Technology. 2016; 48(2):67–70
Corresponding Author
Dr Sumanta Das
Mob: +919836230551, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.