Outcomes of Infant Cardiac Surgery Using Institutional vs Commercial Cardioplegia Solution: A Comparative Analysis.

Area of Science:

• Cardiology
• Pediatric Cardiac Surgery
• Cardioplegia Solutions

Background:

• Infant cardiac surgery requires specialized cardioplegia solutions.
• Assessing myocardial injury markers is crucial for evaluating surgical outcomes.
• Comparing del Nido solution with institutional standards provides valuable clinical insights.

Purpose of the Study:

• To compare postoperative outcomes in infants undergoing cardiac surgery using del Nido cardioplegia versus an institutional cardioplegia solution.
• To evaluate myocardial injury markers, including troponin I, CK-MB, and heart fatty acid-binding protein.
• To assess secondary clinical outcomes such as length of stay and arrhythmias.

Main Methods:

• Eighty-five infants were enrolled, with 45 receiving del Nido and 40 receiving institutional cardioplegia.
• Primary outcomes measured were serum troponin I, CK-MB, and heart fatty acid-binding protein at various postoperative time points.
• Secondary outcomes included vasoactive inotropic score, arrhythmias, ejection fraction, ventilation, CTICU, and hospital stay duration, and mortality.

Main Results:

• The del Nido group had higher initial postoperative troponin I and CK-MB levels compared to the institutional group.
• No significant differences were found in heart fatty acid-binding protein levels between the two groups.
• While not statistically significant, patients receiving del Nido cardioplegia had shorter median hospital and CTICU stays.

Conclusions:

• Del Nido cardioplegia is associated with elevated initial postoperative troponin I and CK-MB levels in pediatric cardiac surgery.
• Despite biochemical marker differences, no significant clinical outcome disparities were identified between del Nido and institutional cardioplegia solutions.
• Further research may clarify the long-term clinical implications of these findings.