Effects of Del Nido and Terminal Warm Blood Cardioplegia on Myocardial Protection and Rhythm in Isolated CABG Patients

Abstract

Objective: To investigate the effect of using del Nido cardioplegia+terminal hot-shot blood cardioplegia on myocardial protection and rhythm in isolated coronary bypass patients. Material and methods: A total of 122 patients were given cold (+4-8C') del Nido cardioplegia antegrade and evaluated. Del Nido+terminal warm blood cardioplegia (TWBCP) was applied to 63 patients out of 122 patients, while del Nido cardioplegia alone was applied to the other 59 patients. The preoperative and postoperative data of the patients were recorded and compared. Results: There was a significant statistical difference between the groups, in terms of volume with more cardioplegia in the del Nido+terminal warm blood cardioplegia group. Although there was no significant difference between cardiac arrest times in both groups, a statistically significant difference was found in the del Nido+terminal warm blood cardioplegia group in the starting to work time of the heart. No difference found between the groups regarding myocardial preservation. Conclusions: We can add a return to spontaneous sinus rhythm to the advantages of terminal warm blood cardioplegia and del Nido cardioplegia in literature. We think it would be a good strategy to extend the safe ischemic time limit of del Nido to 120 minutes with a terminal warm blood cardioplegia. It seems that cardioplegia techniques that will be developed by adding the successful and superior results of crystalloid cardioplegia applications, such as single dose del Nido in various open heart surgery operations and the superior myocardial return effects of terminal warm blood cardioplegia, will be used routinely in the future.

Efficacy and Safety of Multidose del Nido Cardioplegia for Optimal Myocardial Protection in Isolated Coronary Artery Bypass Grafting Surgery: A Comparative Retrospective Cohort Study

“…The lower frequency of defibrillation and inotropic support required in DNC might be due to its low calcium and high lidocaine concentration, which may prevent intracellular calcium accumulation during ischemia, minimizing myocardial damage after reperfusion [2]. Furthermore, similar to a recently published study [25], we included a terminal warm blood 'hot shot' before cross-clamp removal to our DNC delivery protocol, which may have contributed to these findings. It is noteworthy to mention that patients who received DNC with prolonged ischemic time tended higher rates of inotropic support and LCOS, although statistical significance was not reached.…”