Myocardial Protection in Adult Cardiac Surgery With del Nido Versus Blood Cardioplegia: A Systematic Review and Meta-Analysis

Misra, Satyajeet; Srinivasan, Anand; Jena, Sritam Swarup; Bellapukonda, Snigdha

doi:10.1016/j.hlc.2020.10.016

Cited by 27 publications

(28 citation statements)

References 45 publications

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“…[17][18][19] Our study findings are also supported by recently published systematic review and meta-analysis on del Nido versus blood cardioplegia in adult cardiac surgery. 20 A previous study reported that decreased administration for patients receiving the Del Nido cardioplegia 16 which was inconsistent with this study as we found there was no significant statistical association between the type of cardioplegia and the possibility of receiving the RBCs transfusion. We suggest use of ultrafiltration decreases red blood transfusion when high crystalloid-based solution is used.…”

Section: Discussioncontrasting

confidence: 93%

Analogy of Del Nido and conventional cardioplegia in patients undergoing isolated mitral valve replacement surgery: A single-center retrospective study

Rai

Chandrababu

Kamath

et al. 2021

Clinical Epidemiology and Global Health

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The objective of this study was to assess the postoperative outcomes after utilizing the Del Nido cardioplegia as compared to conventional cardioplegia, in patients undergoing isolated mitral valve replacement surgery. Methods: This was a single-center retrospective study conducted with the data from 80 patients with mitral valve disease, who underwent cardiopulmonary bypass. The outcome assessments of the Del Nido group (n = 40) was compared with that of the non-Del Nido group (n = 40). Various time factors were analyzed as end points that included cardiopulmonary bypass time aortic cross clamp time, duration of mechanical ventilation, need for postoperative inotropic support, volume of packed red blood cells (RBCs) transfusion, length of ICU and hospital stay, among others. Results: The current study showed that the mean cardiopulmonary bypass time and aortic cross-clamp time were significantly shorter in the Del Nido group when compared to the non-Del Nido group (P < 0.05). The mean number of packed red blood cell pints administered in the Del Nido group was fewer than the non-Del Nido group (P < 0.05). No significant differences found in other outcome measures. Conclusion:The use of the Del Nido cardioplegia technique did significantly reduce the aortic cross-clamping time and cardio-pulmonary bypass time. The present study did also show a marked reduction in the amount of packed RBCs transfusion in the Del Nido group as compared to non-Del Nido conventional cardioplegia. Rigorous, adequately scrutinized randomized control trials are required to reiterate these findings in-order to enable us to extrapolate their benefits to a larger population.

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Section: Discussioncontrasting

confidence: 93%

Analogy of Del Nido and conventional cardioplegia in patients undergoing isolated mitral valve replacement surgery: A single-center retrospective study

Rai

Chandrababu

Kamath

et al. 2021

Clinical Epidemiology and Global Health

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“…They concluded shorter stay to be the direct result of reduce CPB times and less hemodilution offered by DN cardioplegia than others. 24 One of the most important restraints for adaptation of newer techniques in economically challenged countries like Pakistan is cost effectiveness. DN solution is advantageous is this respect.…”

Section: Discussionmentioning

confidence: 99%

“…They concluded shorter stay to be the direct result of reduce CPB times and less hemodilution offered by DN cardioplegia than others. 24 …”

Section: Discussionmentioning

confidence: 99%

Prospective randomized study comparing outcome of myocardial protection with Del-Nido Cardioplegia versus Saint Thomas Cardioplegia in adult cardiac surgical patients

et al. 2022

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Objectives: To compare the effectiveness of Del-Nido cardioplegia as myocardial protective agent with Saint Thomas cardioplegia in adult cardiac surgical patients. Methods: This prospective randomized study was conducted in cardiac surgery department of Bahawal Victoria hospital Bahawalpur, from October 2020 to March 2021. Eighty adult patients who underwent primary Isolated coronary artery bypass grafting (CABG) or isolated Valve surgery requiring cardiopulmonary bypass were randomly divided into Del Nido (DN, n=40) and Saint Thomas (ST, n=40) groups. Data regarding operative and post-operative variables such as cardiopulmonary bypass (CPB) and aortic cross clamp (AXC) times, inotropic requirements, resumption of sinus rhythm, need for electrical defibrillation, post-operative CKMB, blood requirement and ICU stay were noted. Results: CPB and AXC times were statistically insignificantly different. Resumption of Sinus rhythm was seen significantly in more patients of DN group (95%) than in ST group (72.5%) [p-value 0.05]. Less patients of DN group (5%) were candidates of electrical defibrillation than ST group (17.5%) [p-value <0.001). Post- operative CKMB values were significantly lower in DN group as compared to ST group (30.5±22.6 IU vs 50.5±50.28 IU, p value.008). Blood transfusion was significantly lower in DN group; 50% versus 80% in ST group (p-value 0.005). Ventilation time was significantly less in DN group than ST group (165.95±48.09 minutes versus 165.95±48.09 minutes respectively, p-value 0.03). While ICU stay was also less in DN group; 5.2±0.8 days versus 6.05±1.6 days in ST group (p-value 0.003). Conclusion: Del-Nido cardioplegia is a reliable and better myocardial protective agent than Saint Thomas cardioplegia in adult cardiac surgical procedures. doi: https://doi.org/10.12669/pjms.38.3.4730 How to cite this:Rizvi MFA, Yousuf SMA, Younas A, Baig MAR. Prospective randomized study comparing outcome of myocardial protection with Del-Nido Cardioplegia versus Saint Thomas Cardioplegia in adult cardiac surgical patients. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4730 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…Therefore, it is more important to prevent ventricular fibrillation with an effective cardioplegia strategy than to treat it after it occurs [Buel 2020]. Low defibrillation rates were associated with del Nido cardioplegia in a total of six studies consisting of three studies, each involving 465 adult and 550 [Almeida 2021;Misra 2021]. In addition to this superior feature of del Nido cardioplegia, in our study, the need for defibrillation was found to be significantly less in the MDN group compared with the classical del Nido group.…”

Section: Discussionmentioning

confidence: 99%

Is Modified Del Nido Cardioplegia as Effective as Del Nido Cardioplegia in Patients With Isolated Coronary Artery Bypass Surgery?

Karaarslan

Erdinç

2022

HSF

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Objective: Is modified del Nido cardioplegia superior to del Nido cardioplegia in coronary artery bypass patients? Material and methods: All patients underwent cardiopulmonary bypass and retrospectively were analyzed. A total of 70 patients were included in the study. Thirty-four patients who were given cold (+ 4-8C ') modified del Nido cardioplegia antegrade were evaluated. Other patients received classical del Nido cardioplegia. Hot shot warm blood cardioplegia was given to all patients before the cross-clamp was removed. The results of both groups were compared. Results: There was no significant difference between cardiac arrest times in both groups. A statistically significant difference was found in the modified del Nido cardioplegia group in the working of the heart. Less fibrillation was observed in the modified del Nido cardioplegia group. No difference found between the groups, regarding myocardial preservation. No decrease in hemoglobin was observed in the modified del Nido group on the postoperative first day. Conclusions: We know that return to spontaneous sinus rhythm and fibrillation reduces ischemia-reperfusion injury. At the same time, we can see that epicardial edema was less in the modified del Nido group. We think that less anemia is an advantage of modified del Nido cardioplegia.

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Myocardial Protection in Adult Cardiac Surgery With del Nido Versus Blood Cardioplegia: A Systematic Review and Meta-Analysis

Cited by 27 publications

References 45 publications

Analogy of Del Nido and conventional cardioplegia in patients undergoing isolated mitral valve replacement surgery: A single-center retrospective study

Analogy of Del Nido and conventional cardioplegia in patients undergoing isolated mitral valve replacement surgery: A single-center retrospective study

Prospective randomized study comparing outcome of myocardial protection with Del-Nido Cardioplegia versus Saint Thomas Cardioplegia in adult cardiac surgical patients

Is Modified Del Nido Cardioplegia as Effective as Del Nido Cardioplegia in Patients With Isolated Coronary Artery Bypass Surgery?

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