Related Experiment Video
Updated: Oct 15, 2025
08:30
A Porcine Heterotopic Heart Transplantation Protocol for Delivery of Therapeutics to a Cardiac Allograft
Published on: February 14, 2022
2.9K
Del Nido Cardioplegia in Ascending Aortic Surgery
Holliann Willekes1, Jessica Parker2, Justin Fanning3
1Michigan State University College of Human Medicine, Grand Rapids, Michigan.
Seminars in Thoracic and Cardiovascular Surgery
|October 31, 2021
Summary
Del Nido cardioplegia provides comparable myocardial protection and clinical outcomes to blood cardioplegia in complex ascending aortic surgeries, even with extended cross-clamp times. This study found no significant differences in major adverse events or long-term survival between the two methods.
Area of Science:
- Cardiology
- Cardiac Surgery
- Cardioplegia Solutions
Background:
- Del Nido cardioplegia is known for equivalent myocardial protection in standard adult cardiac surgeries.
- Its safety and efficacy in complex procedures, particularly those with prolonged aortic cross-clamp times, remain less understood.
Purpose of the Study:
- To evaluate the safety and efficacy of Del Nido cardioplegia compared to blood cardioplegia in patients undergoing ascending aorta replacement.
- To assess outcomes in complex cases with extended aortic cross-clamp durations.
Main Methods:
- A retrospective analysis of 443 patients undergoing ascending aorta replacement, utilizing either Del Nido (n=182) or blood (n=261) cardioplegia.
- Propensity score matching created 172 well-matched pairs, including emergency and reoperative cases.
- Clinical outcomes, perioperative troponin T levels, ejection fraction changes, and 5-year survival were analyzed.
Main Results:
- No significant differences were observed in perioperative mortality, stroke, renal failure, atrial fibrillation, or need for mechanical support between the groups.
- Del Nido cardioplegia showed significantly lower postoperative Troponin T levels (P < 0.0001).
- Subgroup analysis of patients with cross-clamp times >180 minutes revealed no differences in myocardial protection or clinical outcomes.
Conclusions:
- Del Nido cardioplegia is a safe and effective alternative to blood cardioplegia for ascending aorta replacement, even in complex cases with prolonged aortic cross-clamp times.
- It offers comparable clinical outcomes and myocardial protection, with potentially improved myocardial enzyme profiles.
