Introduction In this study, we aimed to compare Del Nido cardioplegia (DNC) with blood cardioplegia (BC) in aortic valve replacement. Methods A two-year single-institute retrospective cohort study was accomplished. Subjects who underwent aortic valve replacement surgery were divided into two groups (DNC and BC) and outcomes were compared. Results Preoperative demographics and clinical data of the patients in both groups were similar. The time until cardiac arrest following administration of the first dose of cardioplegia was statistically significantly shorter in the BC group (47.0 sec. 25-103) than in the DNC group (63.0 sec. 48-140) ( P =0.012). Cross-clamping time was longer in the BC group (48.7±12.3 min. vs . 41.5±11.8 min.) ( P =0.041). Cardiopulmonary bypass time was statistically significantly shorter in the DNC group (BC 60.8±18.5 min., DNC 53.7±15.2 min.) ( P =0.046). The rate of postoperative use of intravenous positive inotropic support drugs (dopamine, dobutamine, norepinephrine, etc.) for more than two hours was significantly higher in the BC group (20 [23.5%] in the BC group and nine [17.3%] in the DNC group) ( P =0.035). Creatine kinase myocardial band and troponin I levels were slightly lower in patients receiving DNC, but no statistically significant difference was detected. Conclusion Del Nido cardioplegia is safe and can be used efficiently as an alternative to blood cardioplegia in isolated aortic valve replacement surgery.

Objective The aim of this study was to compare the anaesthesia parameters, procedure duration, and the effect on hemodynamics and clinical parameters during the procedure in patients undergoing transesophageal echocardiography (TEE) with conscious sedation applied with midazolam or propofol. Methods This cross-sectional study included 401 patients (198 males, 203 females, mean age 52.9 ± 14.8 years) applied with TEE in our clinic. The demographic, clinical and laboratory parameters of the patients were recorded before the procedure. A record was made of pre-procedure ASA score and basal SaO2, the time to sedation to TEE, TEE duration, time to recovery, and during the procedure the minimum SaO2, the need for non-invasive mechanical ventilation (NIMV), the change in systolic and diastolic blood pressure (SBP and DBP), O2 saturation change, and pulse change. The data were compared between the patients in two groups according to the conscious sedation agent used; midazolam and propofol. Results The demographic, clinical, and laboratory data of the midazolam and propofol groups were found to be similar (p > 0.05 for each). The procedure duration, and time to recovery were determined to be significantly shorter in the midazolam group than in the propofol group, and the time to onset of the sedation effect was significantly longer (p < 0.05 for each). Of the respiratory parameters, the minimum SaO2 during the procedure, the absolute change in O2 saturation, and the need for NIMV were determined to be significantly lower in the midazolam group (p < 0.05 for each). The absolute pulse and change in SBP and DBP values were found to be significantly higher in the propofol group (p < 0.05 for each). Conclusions The study results demonstrated that conscious sedation applied with midazolam during TEE can be applied with a shorter procedure duration and better hemodynamic and clinical results compared to sedation with propofol.

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