Custodiol Versus Del Nido Cardioplegia in Minimally Invasive Mitral Valve Repair-a Propensity Score-Matched Study

Area of Science:

• Cardiovascular Surgery
• Cardiac Anesthesia
• Cardioplegia Solutions

Background:

• Minimally invasive mitral valve repair is standard for mitral regurgitation.
• Custodiol and Del Nido cardioplegia are common, but comparative data are limited.
• This study compares their efficacy and safety in minimally invasive mitral valve repair.

Purpose of the Study:

• To compare the efficacy and safety of Custodiol versus Del Nido cardioplegia.
• To evaluate myocardial protection using cardiac enzyme dynamics.
• To assess early clinical outcomes in a propensity-matched cohort.

Main Methods:

• Retrospective, single-center, matched cohort study (n=778).
• Propensity score matching based on risk factors and procedural parameters.
• Primary outcome: perioperative cardiac enzyme dynamics; secondary: clinical outcomes.

Main Results:

• Del Nido associated with lower postoperative creatine kinase and CK-MB (p<0.001).
• Del Nido showed lower inotrope score, higher sodium, and fewer ventricular arrhythmias post-declamping (p<0.001).
• Major complications and 30-day mortality were similar (0% in both groups).

Conclusions:

• Del Nido cardioplegia provides superior myocardial protection and reduces post-cross-clamp arrhythmias.
• Clinical outcomes were comparable between Custodiol and Del Nido.
• Del Nido may be the preferred single-dose cardioplegic solution for minimally invasive mitral valve repair.