Comparison of Del Nido and St. Thomas Cardioplegia in adult cardiac surgery

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.

Comparative study between the use of St. Thomas' II cardioplegia and del Nido cardioplegia in patients who underwent open-heart surgery

“…4 In the context of cardiac surgery, myocardial protection refers to the strategies and techniques used during the surgery to prevent ischemic reperfusion injury. 5,6 These strategies help lower the heart's metabolic demands, minimizing myocardial stunning and perioperative necrosis. 5 In 1975 Hearse and associates at St. Thomas' hospital in London took a slightly different approach to chemical cardioplegia.…”

“…5,6 These strategies help lower the heart's metabolic demands, minimizing myocardial stunning and perioperative necrosis. 5 In 1975 Hearse and associates at St. Thomas' hospital in London took a slightly different approach to chemical cardioplegia. Rather than using an intracellular solution, these investigators developed a predominantly extracellular formula based on sodium as the primary cation.…”