Comparison of Del Nido and Intermittent Warm Blood Cardioplegia in Coronary Artery Bypass Grafting Surgery

Uçak, Hacı Ali; Uncu, Hasan

doi:10.5761/atcs.oa.18-00087

Cited by 32 publications

(41 citation statements)

References 22 publications

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“…Administration of cold blood cardioplegia solution every 20 min increases the volume of cardioplegia solution. In the study performed by Ucak et al, in patients who underwent coronary bypass by using del Nido cardioplegia solution and blood cardioplegia solution, the cross clamp time and total CPB durations were shorter, and total volume of cardioplegia solution was less in del Nido cardioplegia solution, similar to our study [24]. In our study, there was no statistically significant difference between the groups in terms of intraoperative defibrillation requirement, LCOS, postoperative AF, postoperative kidney failure, intensive care stay and hospitalisation.…”

Section: Discussionsupporting

confidence: 90%

Evaluation of the cardioprotective effects of crystalloid del Nido cardioplegia solution via a rapid and accurate cardiac marker: heart-type fatty acid-binding protein

Kirişçi¹,

Koçarslan²,

Aykan³

et al. 2020

Turk J Med Sci

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Background/aim: Our aim in this study was to compare the efficacy and safety of crystalloid del Nido solution and cold blood cardioplegia solution on clinical and laboratory parameters. Materials and methods: Sixty patients who underwent elective coronary bypass operation between July 2019 and January 2020 were included in our study. Patients were divided into 2 groups of 30 patients using del Nido solution (DNS) and cold blood cardioplegia solution (CBCS), which were given for cardiac arrest. Demographic data, preoperative, postoperative 0th h, 6th h and 4th day creatine kinase myocardial band (CK-MB) and troponin I values were compared with a specific cardiac enzyme heart-type fatty acid-binding protein (H-FABP). Results: We found that aortic cross clamp duration and cardiopulmonary bypass (CPB) time were shorter in patients using del Nido solution than cold blood cardioplegia solution (57.30 ± 23.57 min, 76.07 ± 27.18 min, P = 0.006) (95.07 ± 23.06 min, 114.13 ± 33.93, P = 0.014). Total cardioplegia solution volume was higher in the cold blood cardioplegia solution group (1426.67 ± 416.00 vs. 1200 ± 310.73 P = 0.02). Preoperative and postoperative levels of cardiac enzymes including CK-MB, troponin I and H-FABP were comparable in del Nido solution and cold blood cardioplegia solution groups. Conclusion: According to these results, when we compare both demographic data and CK-MB, troponin I and H-FABP levels, both cardioplegia solutions were comparable regarding safety and efficacy in terms of myocardial protection.

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Section: Discussionsupporting

confidence: 90%

Evaluation of the cardioprotective effects of crystalloid del Nido cardioplegia solution via a rapid and accurate cardiac marker: heart-type fatty acid-binding protein

Kirişçi¹,

Koçarslan²,

Aykan³

et al. 2020

Turk J Med Sci

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“…Two recently published Randomized Controlled Trials (RCT) compared the use of the DNC to the intermittent whole blood cardioplegia in CABG or CABG plus valve surgery. Ucak et al [25] could observe shorter aortic cross-clamp and CPBP times and better glucose control in the DNC group, without meaningful clinical differences in a population with an average Euroscore of 4.1. Similarly, Ad et al [26] conducted the single registered RCT (NCT02442050) for the DNC in adults.…”

Section: Experiences In Adult Patientsmentioning

confidence: 94%

“…CPB, X-clamp time Complication rates Inotropic support Need defibrillation UCAK et al . [25] CABG elective DNC = 112 IWBC =185…”

Section: Deliver and Technical Aspectsmentioning

confidence: 99%

Del Nido cardioplegia: from an infant conceive to an adult life - a brief review of the current evidence in adult patients

Pragliola¹,

Hassan²,

Hossan³

et al. 2019

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The increasing number of minimally invasive procedures prompted the quest for a simple and effective single shot cardioplegia to allow the surgeons to focus on their workflow. The originally pediatric Del Nido solution was successfully tested in several centers and gradually extended to regular coronary and valvular cases. In the present review we report the current evidence on the use of the Del Nido solution in adult patients.

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“…13,14 O'Blenes et al 15 reported that the use of DN solution prevented spontaneous calcium -induced hypercontraction during cardiac arrest, reduced troponin release, and provided superior myocardial protection in isolated The ACC and CPB times were longer in patients undergoing surgery with DN cardioplegia, which is in contrast to previously published trials. 10,11 This was expected due to the inclusion of longer surgeries (valve and combined operations) in our trial, most of which were performed with DN cardioplegia. Compared with CB cardioplegia, patients receiving DN cardioplegia demonstrated higher postoperative troponin T levels, likely as a result of longer ACC and CPB times.…”

mentioning

confidence: 99%

“…In the majority of cardiac surgeries, a single application should be sufficient. 10 Importantly, less frequent dosing allows an uninterrupted surgery. logistic regression was adjusted for the propensity score for DN cardioplegia.…”

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confidence: 99%

Del Nido cardioplegia as a safe and effective method of myocardial protection in adult patients undergoing cardiac surgery: a single‑center experience

2019

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Background Del Nido (DN) cardioplegia is increasingly popular in adult cardiac surgery. It allegedly allows for up to 90 minutes of safe myocardial ischemia with a single dose. aims We aimed to evaluate the benefits of DN cardioplegia. methods Of the 2108 patients undergoing coronary or heart valve surgery with the use of cardiopulmonary bypass (CPB) between January 1, 2016, and September 30, 2017, 1236 (59%) received DN and 872 (41%) received cold blood cardioplegia. We retrospectively analyzed the collected data of all consecutive on pump patients to assess early mortality and postoperative troponin T release. A multivariable analysis of both outcomes adjusted for propensity to receive DN cardioplegia was performed. results Patients protected with DN cardioplegia had longer CPB and aortic cross clamp times (P <0.001) but received fewer doses of cardioplegia. Median postoperative troponin T levels were higher in the DN cardioplegia than CB cardioplegia group: 0.324 ng/ml (interquartile range [IQR], 0.210-0.559 ng/ml) vs 0.285 ng/ml (IQR, 0.191-0.496 ng/ml); P = 0.01. However, when adjusted for the cross clamp time, propensity to receive DN cardioplegia, and other factors, DN cardioplegia was associated with lower postoperative troponin T levels. Early mortality rates did not differ between DN and CB cardioplegia (3.6% vs 3%; P = 0.54). conclusions Del Nido cardioplegia is a safe and effective method of myocardial protection in adults. It allows for a longer redosing interval with a safety profile and mortality comparable to those for CB cardioplegia, as shown by lower troponin T release when corrected for the time of myocardial ischemia.

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Comparison of Del Nido and Intermittent Warm Blood Cardioplegia in Coronary Artery Bypass Grafting Surgery

Abstract: 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.

Cited by 32 publications

References 22 publications

Evaluation of the cardioprotective effects of crystalloid del Nido cardioplegia solution via a rapid and accurate cardiac marker: heart-type fatty acid-binding protein

Evaluation of the cardioprotective effects of crystalloid del Nido cardioplegia solution via a rapid and accurate cardiac marker: heart-type fatty acid-binding protein

Del Nido cardioplegia: from an infant conceive to an adult life - a brief review of the current evidence in adult patients

Del Nido cardioplegia as a safe and effective method of myocardial protection in adult patients undergoing cardiac surgery: a single‑center experience

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