Del Nido cardioplegia was developed for immature heart and pediatric surgery. But in our opinion, it is a good and useful alternative to CABG surgery with similar results to IWBC.

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.

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Background: Coronary collateral circulation (CCC) is a small vascular formation that allows the connection between the different parts of an epicardial vessel or other vessels. The presence of collateral circulation contributes positively to the course of coronary artery disease (CAD). The aim of this study was to investigate the effect of collateral circulation on myocardial injury and clinical outcomes during coronary artery bypass grafting (CABG) in a high-risk patient group. Methods: 386 patients who underwent isolated CABG under cardiopulmonary bypass (CPB) were included in the study. Patients were divided into two groups according to the Rentrop scores (n = 225 poor CCC group; and n = 161 good CCC group). Myocardial injury and postoperative clinical results were evaluated as endpoints. Results: The mean age was 62.9 ± 7.5 years, and 61.6% of all patients were male. Postoperative 30-day mortality rate was significantly higher in poor CCC group (4 [1.7%] and 1 [0.6%], P < .001). The frequency of postoperative intraaortic balloon pump (IABP) use (5 [2.2%] and 1 [0.6%], P < .001), low cardiac output syndrome (LCOS) (28 [12.4%] and 10 [6.2%], P < .001) and postoperative atrial fibrillation (35 [15.6%] and 16 [9.9%], P = .038) were significantly higher in poor CCC group. 12th and 24th hour CK-MB and cTn-I values were found to be significantly lower in the good CCC group. Conclusion: It is inevitable that the CPB circuit and operation have devastating effects on myocardium in CABG operations. The presence of CCC reduces postoperative myocardial injury, low cardiac output syndrome, and mortality rates.