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Propensity-Matched Analysis of Del Nido Cardioplegia in Adults Undergoing Cardiac Surgery with Prolonged
Utkan Sevuk1, Seyithan Dursun2, Elif Sevgi Ar2
1Department of Cardiovascular Surgery, Diyarbakir Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.
Insights
Del Nido cardioplegia is a safe alternative for cardiac surgery, even with extended cross-clamping times. This study found no significant differences in patient outcomes compared to cold blood cardioplegia.
Area of Science:
- Cardiovascular Surgery
- Anesthesiology
- Cardioplegia Solutions
Background:
- Limited data exists on del Nido cardioplegia safety and efficacy in prolonged aortic cross-clamping.
- Cold blood cardioplegia is a standard but may have limitations in complex cases.
Purpose of the Study:
- To compare the efficacy and safety of del Nido cardioplegia versus cold blood cardioplegia.
- To evaluate outcomes in adult cardiac surgery patients requiring prolonged aortic cross-clamping time (≥ 90 minutes).
Main Methods:
- Retrospective study comparing 88 del Nido cardioplegia patients with 88 propensity score-matched cold blood cardioplegia patients.
- Inclusion criteria: adult cardiac surgery with aortic cross-clamping time ≥ 90 minutes.
Main Results:
- No significant differences observed in intraoperative defibrillation, postoperative peak troponin T, inotropic support, or intra-aortic balloon pump use.
- Left ventricular ejection fraction, cardiopulmonary bypass time, and total operation time were comparable between groups.
- Mean cross-clamping time was significantly shorter in the del Nido cardioplegia group (P<0.001).
Conclusions:
- Del Nido cardioplegia presents a safe alternative to cold blood cardioplegia for adult cardiac surgery.
- The findings support the use of del Nido cardioplegia in procedures involving prolonged aortic cross-clamping.
Introduction:
There is not enough data in the literature regarding the safety and efficiency of del Nido cardioplegia in patients with prolonged cross-clamping time. This study aims to determine the efficacy and safety of del Nido cardioplegia compared to cold blood cardioplegia in patients with prolonged aortic cross-clamping time.
Methods:
In this retrospective study, patients with an aortic cross-clamping time ≥ 90 minutes were included. One hundred consecutive adult patients undergoing cardiac surgery using del Nido cardioplegia comprised the study group, and 100 consecutive adult patients undergoing cardiac surgical procedures using cold blood cardioplegia comprised the control group. Propensity score matching yielded 88 del Nido cardioplegia and 88 cold blood cardioplegia patients.
Results:
There were no significant differences when comparing the matched groups regarding the requirement for intraoperative defibrillation, postoperative peak troponin T levels, inotropic support, intra-aortic balloon pump requirement, and left ventricular ejection fraction at discharge and on the sixth postoperative month; also, there were no significant differences when comparing cardiopulmonary bypass time and total operation time. Mean cross-clamping time was significantly shorter in the del Nido group (P<0.001).
Conclusion:
Del Nido cardioplegia may be a safe alternative to cold blood cardioplegia in adults undergoing cardiac surgical procedures with prolonged aortic cross-clamping time.
