Del-Nido cardioplegia in cardiac surgery for elderly patients: a propensity score-matched analysis

Gu, Wenda; Qing, Hongkun; Luo, Xiang; Zang, Xin; Zhou, Kan; Guo, H M; Zhou, Chengbin; Guo, Huiming; Liu, Jian

doi:10.1186/s13019-023-02269-3

Cited by 3 publications

(1 citation statement)

References 19 publications

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“…Conventional cardioplegia solutions utilize hypothermia and metabolic arrest in order to promote anaerobic glycolysis and scavenging of oxygen-free radicals. 1–4 Additionally, this prevents the accumulation of intracellular calcium. 5,6 However, using conventional cardioplegia solutions results in cardiomyocyte depolarization because these solutions contain high potassium.…”

Section: Introductionmentioning

confidence: 99%

Non-selective Del Nido and St Thomas cardioplegia in adults: analysis of early clinical experience using propensity matching

Sazzad,

Ong,

Ong

et al. 2023

Therapeutic Advances in Cardiovascular Disease

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Background: Del Nido cardioplegia (DNC) is a single-dose, high potassium, low-volume cardioplegia solution that has grown in favor recently. However, the use of DNC in the Asian population may be associated with certain challenges. Methods: Between January 2017 and April 2022, DNC was used for myocardial protection in this single-center retrospective study. In total, 5731 patients underwent open heart surgeries, where 310 patients received DNC for single or multiple procedures. A total of 307 pair of propensity-matched patients from DNC and cold blood St. Thomas cardioplegia (STC) were compared. Results: In total, 5085 patients with STC and 310 patients with DNC from the cohort were matched, reflecting the initial group sizes before propensity matching. About 307 patient pairs were included in the final analysis after propensity matching with the interest variables. In the STC group, the requirement for an immediate postoperative intra-aortic balloon pump (IABP) was significantly higher [18 (5.9%) in DNC versus 28 (9.1%) in STC, p = 0.021]. A 30-day mortality was comparable between the DNC and STC groups (2.9% versus 3.3%, p = 1.00). Major adverse cardiac events (MACE) (2.6% versus 3.6%, p = 0.648) showed no difference between the groups. In both single and multiple procedure subgroups, there were no statistically significant differences in 30-day mortality and MACE incidences when comparing STC and DNC. Conclusion: The use of DNC in adults is acceptable and adaptable. Comparable clinical outcomes between STC patients and DNC were revealed by our investigation. There were no appreciable differences in 30-day mortality or MACE despite the STC group having a much higher need for immediate postoperative IABP.

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Section: Introductionmentioning

confidence: 99%

Non-selective Del Nido and St Thomas cardioplegia in adults: analysis of early clinical experience using propensity matching

Sazzad,

Ong,

Ong

et al. 2023

Therapeutic Advances in Cardiovascular Disease

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Modern concepts of cardioplegia

Saemann,

Szabó

2024

Z Herz- Thorax- Gefäßchir

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Comparison of modified Del Nido and Custodiol® cardioplegia in minimally invasive mitral valve surgery

Kang,

Hoyer,

Dieterlen

et al. 2024

European Journal of Cardio-Thoracic Surgery

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OBJECTIVES In this study, we evaluated if modified Del Nido cardioplegia delivers comparable cardiac protection in comparison to Custodiol® in patients undergoing isolated minimally invasive mitral valve repair. METHODS From 01/2018 to 10/2021 all patients undergoing non emergent isolated minimally invasive mitral valve repair were included in this study. The cardioplegia was chosen at the surgeons’ discretion. The primary end-points of this study were peak postoperative cardiac enzyme levels. Secondary end-points were in-hospital mortality, hospital stay, occurrence of cardiac arrhythmias, pacemaker implantations, postoperative lactate and sodium levels and postoperative incidence of renal failure requiring dialysis. RESULTS A total of 355 patients were included in this study. The mean age of patients was 57. After propensity score matching, a total of 156 pairs were identified. There was no difference in cross-clamp time between both groups. Postoperative Creatine kinase levels were higher in patients receiving Custodiol® on the 1st and 2nd postoperative day. CK-MB levels were higher in patients receiving Custodiol® on the 2nd postoperative day (0.5 ± 0.2 µmol/L*s vs 0.4 ± 0.1 µmol/L*s; p < 0.001). Postoperative Troponin T concentrations were similar between both groups. Maximum lactate concentrations were higher in patients receiving Custodiol on the day of surgery (2.4 ± 1.9 mmol/L vs 2.0 ± 1.1 mmol/L; p = 0.04). The overall hospital stay was longer in patients receiving Del Nido cardioplegia (10.6 ± 3.2 days vs 8 ± 4.1 days; p < 0.01). CONCLUSIONS Modified Del Nido cardioplegia based on Ionosteril® solution offers equivalent protection compared to Custodiol® for isolated minimally invasive mitral valve repair.

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Del-Nido cardioplegia in cardiac surgery for elderly patients: a propensity score-matched analysis

Cited by 3 publications

References 19 publications

Non-selective Del Nido and St Thomas cardioplegia in adults: analysis of early clinical experience using propensity matching

Non-selective Del Nido and St Thomas cardioplegia in adults: analysis of early clinical experience using propensity matching

Modern concepts of cardioplegia

Comparison of modified Del Nido and Custodiol® cardioplegia in minimally invasive mitral valve surgery

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