Protecting the aged heart during cardiac surgery: Use of del Nido cardioplegia provides superior functional recovery in isolated hearts

Govindapillai, Arun; Hua, Rui; Rose, Robert A.; Friesen, Camille L. Hancock; O’Blenes, Stacy B.

doi:10.1016/j.jtcvs.2013.05.032

Cited by 80 publications

(85 citation statements)

References 34 publications

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“…The potential benefits of DNC have also been corroborated in experimental studies. Several animal models comparing DNC to other cardioplegic solutions have demonstrated superiority in reduction of electrical activity after arrest and decrease calcium accumulation in myocytes …”

Section: Discussionmentioning

confidence: 99%

Del Nido cardioplegia for minimally invasive aortic valve replacement

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Del Nido cardioplegia for minimally invasive aortic valve replacement

et al. 2018

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“…Later, they also showed that, in a similar setting of aged hearts, single-dose DN cardioplegia was also associated with superior calcium handling of cardiomyocytes, reduced myocardial injury, and improved functional recovery [13]. However, these findings need to be confirmed using more clinically relevant methodology, and their effect on long-term post-operative ventricular function should be examined.…”

Section: Discussionmentioning

confidence: 99%

Comparison of del Nido cardioplegia and St. Thomas Hospital solution – two types of cardioplegia in adult cardiac surgery

Mishra

Jadhav

Mohapatra

et al. 2016

kitp

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IntroductionSt. Thomas’ cardioplegic solution No. 2 (ST), although most widely used in adult cardiac surgery, needs to be given at short intervals, causing additional myocardial injury.AimTo determine whether del Nido (DN) cardioplegia, with longer periods of arrest, provides equivalent myocardial protection as compared to ST.Material and methodsThe study population comprised 100 patients who underwent elective coronary artery bypass grafting (CABG) or double valve replacement (DVR) surgery between January 2015 and January 2016. The patients were divided into two groups based on the type of cardioplegia administered during surgery: 1) intermittent ST (ST, n = 50) and 2) DN cardioplegia (DN, n = 50). We compared the aortic cross clamp (CC) and cardiopulmonary bypass (CPB) times, number of intra-operative DC shocks required, and postoperative changes in left ventricular ejection fraction (LVEF) in the two groups.ResultsThe aortic cross clamp and bypass times were shorter with DN (110.15 ±36.84 vs. 133.56 ±35.66 and 158.60 ±39.92 vs. 179.81 ±42.36 min respectively, p < 0.05). Fewer cardioplegia doses were required in the DN group vs. the ST group (1.38 ±0.59 vs. 4.15 ±1.26; p = 0.001), while a single cardioplegia dose was given to 35 DN patients (70%) vs. 0 ST patients (p < 0.001). Postoperative LVEF was better preserved in the DN group.ConclusionsThe use of DN leads to shorter cross clamp and CPB times, reduces cardioplegia dosage, and provides potentially better myocardial protection in terms of LVEF preservation, with a safety profile comparable to ST cardioplegia.

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“…4 Given the ease of administration, and the potential for reducing surgical interruption and cost, interest in del Nido solution has been increasing in the adult cardiac community. 4 Although there is a large body of unpublished experience regarding its use in adults at some centers, and a small amount of animal data, 5,6 published clinical data are scant. No randomized trial has been launched to investigate the comparative safety of these 2 cardioplegia methods.…”

mentioning

confidence: 99%