Single-Dose Del Nido Cardioplegia vs. Blood Cardioplegia in Aortic Valve Replacement Surgery

• Published in: Revista brasileira de cirurgia cardiovascular Vol. 36; no. 2; pp. 229 - 236
• Main Authors: Ucak, Haci Ali, Ucak, Dilek
• Format: Journal Article
• Language: English
• Published: Sao Paulo Sociedade Brasileira de Cirurgia Cardiovascular 01.01.2021
• Subjects: Aortic Valve; Blood; CARDIAC & CARDIOVASCULAR SYSTEMS; Cardiac arrhythmia; Cardioplegic Solutions; Cardiopulmonary Bypass; Cardiovascular Agents; Chronic obstructive pulmonary disease; Creatinine; Drug dosages; Ejection fraction; Heart Arrest, Induced; Heart surgery; Heart Valve Prosthesis; Intensive care; Ischemia; Leukocytes; Original; Patients; Potassium; Surgeons; SURGERY; New York; United States > US; Heart Arrest, Induced; Cardiovascular Agents; Cardiopulmonary Bypass; Heart Valve Prosthesis; Cardioplegic Solutions; Aortic Valve
• ISSN: 1678-9741; 0102-7638; 1678-9741
• DOI: 10.21470/1678-9741-2020-0063

Introduction: In this study, we aimed to compare Del Nido cardioplegia (DNC) with blood cardioplegia (BC) in aortic valve replacement. Methods: A two-year single-institute retrospective cohort study was accomplished. Subjects who underwent aortic valve replacement surgery were divided into two groups (DNC and BC) and outcomes were compared. Results: Preoperative demographics and clinical data of the patients in both groups were similar. The time until cardiac arrest following administration of the first dose of cardioplegia was statistically significantly shorter in the BC group (47.0 sec. 25-103) than in the DNC group (63.0 sec. 48-140) (P=0.012). Cross-clamping time was longer in the BC group (48.7±12.3 min. vs. 41.5±11.8 min.) (P=0.041). Cardiopulmonary bypass time was statistically significantly shorter in the DNC group (BC 60.8±18.5 min., DNC 53.7±15.2 min.) (P=0.046). The rate of postoperative use of intravenous positive inotropic support drugs (dopamine, dobutamine, norepinephrine, etc.) for more than two hours was significantly higher in the BC group (20 [23.5%] in the BC group and nine [17.3%] in the DNC group) (P=0.035). Creatine kinase myocardial band and troponin I levels were slightly lower in patients receiving DNC, but no statistically significant difference was detected. Conclusion: Del Nido cardioplegia is safe and can be used efficiently as an alternative to blood cardioplegia in isolated aortic valve replacement surgery.