Comparison of Del Nido Cardioplegia with Blood Cardioplegia in Adult Combined Surgery

Hamad, Raphael; Nguyen, Albert; Laliberté, Éric; Bouchard, Denis; Lamarche, Yoan; El-Hamamsy, Ismaı̈l; Demers, Philippe

doi:10.1097/imi.0000000000000403

Cited by 33 publications

(52 citation statements)

References 20 publications

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“…Hamad et al. [ 2 ] evaluated the effect of DNC in CABG combined with aortic valve surgery in 25 subjects. CPB time, cross-clamp time, and postoperative CK-MB and troponin levels were lower in the surgeries with use of DNC.…”

Section: Discussionmentioning

confidence: 99%

“…BC requires multiple interruptions, which is an additional factor for ischaemic damage. The single-dose application was associated with a lower cardioplegia volume and less haemodilution, which decreases the transfusion requirement according to literature [ 1 , 2 ] . In the present study, the need for RBCs and platelet transfusion rates were similar in DNC and BC groups.…”

Section: Discussionmentioning

confidence: 99%

“…Cardioplegia is a state of cardiac arrest and cardiac protection induced by the infusion of cardioplegia solution into the myocardium and involves the cessation of myocardial contractions. During cardioplegia, ischaemia occurs in myocardial tissue [ 2 ] . After cross-clamp removal and reperfusion is initiated, a degree of ischaemia/reperfusion injury occurs, which is responsible for most of the complications of cardiac surgery [ 3 ] .…”

Section: Introductionmentioning

confidence: 99%

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Comparison of del Nido Cardioplegia with Blood Cardioplegia in Coronary Artery Bypass Grafting Combined with Mitral Valve Replacement

Kavala¹,

Türkyilmaz²

2018

Braz J Cardiovasc Surg

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ObjectiveTo compare del Nido cardioplegia (DNC) with blood cardioplegia (BC) in coronary artery bypass grafting (CABG) combined with mitral valve replacement.MethodsA 3-year single-center retrospective cohort study was carried out. Subjects who underwent CABG (up to triple bypass) combined with mitral valve replacement were divided into DNC and BC groups. Each group had thirty subjects.ResultsBoth groups demonstrated similar baseline characteristics, including age, gender, cardiac/non-cardiac comorbidity, and preoperative echocardiographic parameters. Compared with the BC group, the DNC group demonstrated significantly lower cardioplegia volume (BC = 1130.00±194.1 mL, DNC = 884.33±156.8 mL, P=0.001), cardiopulmonary bypass time (DNC = 110.90±12.52 min, BC = 121.70±13.57 min, P=0.002), aortic clamp time (DNC = 91.37±11.58 min, BC = 101.37±13.87 min, P=0.004), and need for intraoperative defibrillation (DNC = 6 events, BC = 21 events, P=0.001). Postoperative creatine kinase-MB levels and troponin levels were significantly lower in the DNC group than in the BC group. Postoperative haemoglobin and haematocrit levels were significantly higher in the DNC group than in the BC group. The intubation period (hours) in intensive care unit (ICU) was significantly small in the BC group (DNC = 8.13±12.21, BC = 6.82±1.57, P=0.037); however, ICU stay, total hospital stay, and postoperative complication rates were not significantly different between them. At pre-discharge echocardiography, the DNC group demonstrated significantly higher ejection fraction rates than the BC group (47.79±5.50 and 45.72±5.86, respectively, P=0.005).ConclusionDNC presented better intraoperative and postoperative parameters and it is an effective and safe alternative to BC for CABG combined with mitral valve replacement.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of del Nido Cardioplegia with Blood Cardioplegia in Coronary Artery Bypass Grafting Combined with Mitral Valve Replacement

Kavala¹,

Türkyilmaz²

2018

Braz J Cardiovasc Surg

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“…Hamad et al compared del Nido cardioplegia with blood cardioplegia in adults undergoing aortic valve replacement and concomitant CABG. Primary endpoints were 1‐h post‐operative troponin T and CK‐MB levels.…”

Section: Del Nido Versus Conventional Blood or Crystalloid Cardioplegiamentioning

confidence: 99%

Bretschneider and del Nido solutions: Are they safe for coronary artery bypass grafting? If so, how should we use them?

Siddiqi

Blackstone²,

Bakaeen³

2018

J Card Surg

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A variety of cardioplegic solutions are being used widely today to arrest the heart during coronary artery bypass grafting (CABG) and other cardiac operations. To minimize interruptions during the surgery for intermittent dosing of the cardioplegia and to facilitate less invasive cardiac procedures, single-shot solutions, including Bretschneider and del Nido solutions, have been introduced. This review examines the evidence regarding the safety and efficacy of Bretschneider and del Nido cardioplegia during CABG. The findings support their use in routine low-risk CABG, but finds insufficient evidence to support their safety in high-risk surgeries.

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“…Indeed, studies on routine use of DNC for all categories of adult cardiac surgery including more complex procedures with intermediate or high risk profile patients are limited. 14,15 Our purpose was to bridge this gap in knowledge by comparing routine use of DNC with conventional multidose BC in all categories of adult cardiac surgery procedures with a wide range of procedure's complexity and patient's risk profile. Our hypothesis was that DNC is potentially safe in all comers.…”

Section: Introductionmentioning

confidence: 99%

Routine use of del Nido Cardioplegia compared to blood cardioplegia in all types of adult cardiac surgery procedures

Algarni

2020

Preprint

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Background and aim of the study: Several studies reported safety and potential benefits of single dose Del Nido cardioplegia (DNC) in selected Adult Cardiac Surgery (ACS) procedures. However, studies are scarce on routine use of DNC in more complex procedures and patients with high risk profile. We sought to compare DNC with cold blood cardioplegia (BC) in all types of ACS including complex procedures. Methods: Data for 305 consecutive unselected patients who underwent ACS procedures (July/2017 to Nov/2019) were included. DNC was routinely used whenever is available (n=231) and if not available, cold BC is used (n=74). All categories of ACS procedures (primary or redo) were included. Repeated measures analysis was performed to compare baseline, peak and trough Troponins levels in both groups. Linear regression analysis was used to identify independent predictors of peak Troponins level. Results: The two groups were comparable in baseline characteristics including euro score (ES II), risk profile and surgical complexity. DNC was associated with lower cardiopulmonary bypass (CPB) and cross clamp times, cardioplegia volume and number of cardioplegia doses (P<.001). Importantly, DNC was associated with lower postoperative Troponin level (P=.001), shorter duration of inotropic support (P=.02) and shorter intensive care unit stay (P=.04). On linear regression analysis, DNC was an independent predictor of lower postoperative peak Troponin (t =-3.5, P<.001). Conclusions: Routine use of DNC in all types of ACS procedures compared to BC was associated with significantly shorter CPB and clamp times, significantly lower post-operative troponin release and shorter duration of inotropic support.

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Comparison of Del Nido Cardioplegia with Blood Cardioplegia in Adult Combined Surgery

Cited by 33 publications

References 20 publications

Comparison of del Nido Cardioplegia with Blood Cardioplegia in Coronary Artery Bypass Grafting Combined with Mitral Valve Replacement

Comparison of del Nido Cardioplegia with Blood Cardioplegia in Coronary Artery Bypass Grafting Combined with Mitral Valve Replacement

Bretschneider and del Nido solutions: Are they safe for coronary artery bypass grafting? If so, how should we use them?

Routine use of del Nido Cardioplegia compared to blood cardioplegia in all types of adult cardiac surgery procedures

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