A novel dosing strategy of del Nido cardioplegia in aortic surgery

Chung, Megan M.; Erwin, W Clinton; Ning, Yuming; Zhao, Yanling; Chan, Ching-Kit; d'Angelo, Alex; Kossar, Alexander P.; Spellman, Jessica; Kurlansky, Paul; Takayama, Hiroo

doi:10.1016/j.xjon.2022.04.028

Cited by 5 publications

(2 citation statements)

References 26 publications

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“…For long crossclamp time, acceptable results were also reported with a mixed antegrade + retrograde delivery and the administration of a dilute solution -4:1 blood to crystalloid ratio instead of 1:4 blood to crystalloid ratiofor additional doses. 8,28 In our experience with mean and maximum crossclamp times for del Nido of 56 minutes and 105 minutes, respectively, and no need for further doses after the initial one, the volume of administered cardioplegia was significantly lower for del Nido compared to HTK solution. There was no difference in terms of intraoperative red blood cells transfusion, lowest haematocrit during cardiopulmonary bypass, first postoperative haemoglobin and first postoperative haematocrit between the two groups.…”

Section: Commentmentioning

confidence: 77%

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del Nido and Histidine-Tryptophan-Ketoglutarate cardioplegia in minimally invasive mitral valve surgery: A propensity-Match study

et al. 2023

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Introduction In the last decade, del Nido cardioplegia has been embedded in adult cardiac surgery involving CABG and aortic valve surgical procedures. We reviewed our early experience with del Nido cardioplegia in the setting of minimally invasive mitral valve surgery. Methods Data on 120 consecutive patients operated between 03/2021 and 06/2022 were retrieved from our internal database (infective endocarditis and urgent operations were excluded). Patients were divided into two groups according to the use of Histidine-Tryptophan-Ketoglutarate or del Nido cardioplegia. A propensity match analysis was performed using thirteen preoperative and intraoperative variables. Several intraoperative data and early postoperative outcomes were investigated, including cardiac enzymes (Troponin I HS and CK-MB) measured upon arrival in the Intensive Care Unit (ICU), after 12 hours and everyday thereafter. Results There was no difference in preoperative characteristics and surgical techniques between both unmatched and matched Histidine-Tryptophan-Ketoglutarate and del Nido populations. Patients in the del Nido group received a lower volume of cardioplegia ( p < 0.001) and ultrafiltration during CPB ( p < 0.001). Histidine-Tryptophan-Ketoglutarate was associated with a lower rate of post cross-clamp spontaneous defibrillation ( p < 0.001) and showed a lower level of blood sodium after CPB ( p < 0.001). The release of cardiac enzymes was similar between the two groups ( p = 0.72). There was no difference in terms of postoperative morbidity and 30 day mortality. Conclusions del Nido cardioplegia in the setting of minimally invasive mitral valve surgery seemed safe with acceptable myocardial protection and excellent early outcomes.

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Section: Commentmentioning

confidence: 77%

“…For long crossclamp time, acceptable results were also reported with a mixed antegrade + retrograde delivery and the administration of a dilute solution – 4:1 blood to crystalloid ratio instead of 1:4 blood to crystalloid ratio – for additional doses. 8,28…”

Section: Commentmentioning

confidence: 99%