Recent Experience in the use of Del Nido Cardioplegic Solution in Pediatric Patients

Abstract

Background: The interest in Del Nido cardioplegia for myocardial protection in pediatric cardiac surgery is growing. Research hitherto supports the use of Del Nido cardioplegia in providing myocardial preservation as well as reducing surgery time. Objectives: To contribute to the literature, we sought to share our own experiences and outcomes of 86 pediatric patients who underwent cardiac surgery at our centre in whom this cardioplegic solution was used. Methods: In a retrospective study, we evaluated 86 pediatric patients with congenital cardiac defects who underwent corrective cardiac surgery in whom Del Nido cardioplegic solution was used. Results: The mean age of the patients was 55.1±48.6 months and the mean weight was 16.2±11.4 kilograms. Repair of tetralogy of Fallot and closure of atrial septal defect or ventricular septal defect represented 44% of the operations. Mean cross clamp time was 75.5±38.6 minutes. In five patients (5.8%), cardioversion defibrillation was used to regain sinus rhythm after cross clamp release. Only one patient needed inotropic support grade 3 (epinephrine dose equal or more than 0.1mcg/kg/min), while the remainder were in grade 2 or less. Conclusion: We think that the use of Del Nido cardioplegia in our patients was associated with clinical benefits and decreased morbidity. It can provide appropriate myocardial protection for longer cross clamp times with decreased repeat dosing. However, the preferred cardioplegic solution in congenital cardiac surgery remain highly variable among centers.