Utilization of Del Nido Cardioplegia in Adult Coronary Artery Bypass Grafting　― A Retrospective Analysis ―

Abstract

The protocols and policies followed in this study were approved by the Stanford University Institutional Review Board (IRB 38337). Because of the retrospective nature and minimal risk of our study, individual participant consent was waived. Our study used a validated 'before and after' group level study design to examine the effect of introducing Del Nido cardioplegia as the only variable that was changed in our CABG protocol. All patients who underwent isolated CABG performed by an experienced specialist in coronary revascularization surgery at our institution during a 2-year period from October 2014 to October 2016 were assessed for inclusion. In July 2015, our institution's perfusion protocol for CABG surgery was changed from using BC to solely using DN. Overall, 27 consecutive BC patients (October 2014 to July 2015) and 54 consecutive DN patients (August 2015 to August 2016) were identified. Re-operative procedures and minimally invasive direct coronary artery bypass surgeries, which

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

“…Twenty-nine (29) studies were included in this systematic review and meta-analysis: three RCTs [4,14,15], two prospective observational non-randomised studies [16,17], 16 PMCS [7,8,[18][19][20][21][22][23][24][25][26][27][28][29][30][31], and eight unmatched retrospective cohort studies [5,6,[32][33][34][35][36][37] (Table 1). The majority of the studies used blood cardioplegia in a ratio of 4:1 (blood:crystalloid), with one study using an 8:1 ratio [29], and another study using only blood [4].…”

The application of del Nido cardioplegia for myocardial protection in adult coronary artery bypass grafting: a cohort study

“…Reducing the operating time may not only mitigate myocardial damage to a certain extent, but may also improve the efficiency of operating room usage and reduce the costs of hospital management (5,(11)(12)(13)(14). O'Donnell and colleagues found reported the requirement for defibrillation in a DN group to be significantly less than that a BC group (33.3% in the BC group vs. 13.0% in the DN group) (15). Therefore, reducing defibrillation appear to be highly conducive to postoperative myocardial recovery (16).…”

Endoscopic Radial Artery Harvesting During Anesthesia Line Placement Reduces the Time and Cost of Multivessel Coronary Artery Bypass Grafting

“…The perfusion strategy in all cases involved a single anterograde dose of cold del Nido cardioplegia given down the aortic root. 16 The left anterior descending (LAD) coronary artery was bypassed with a LIMA or RIMA in situ graft in all cases, while standard distal and proximal aortocoronary suture anastomosis technique was used for all RA and SV grafts. No sequential grafts or Y-grafts were used.…”