Abstract

IntroductionIn this study, we aimed to compare Del Nido cardioplegia (DNC) with blood cardioplegia (BC) in aortic valve replacement.MethodsA 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.ResultsPreoperative 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.ConclusionDel Nido cardioplegia is safe and can be used efficiently as an alternative to blood cardioplegia in isolated aortic valve replacement surgery.

Highlights

  • In this study, we aimed to compare Del Nido cardioplegia (DNC) with blood cardioplegia (BC) in aortic valve replacement

  • The aim of this study is to contribute to the literature by comparing the results of DNC and BC delivery during aortic valve replacement in adult patients

  • The present study included a total of 137 patients undergoing aortic valve replacement who met the inclusion criteria within the study period

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Summary

Introduction

We aimed to compare Del Nido cardioplegia (DNC) with blood cardioplegia (BC) in aortic valve replacement. Despite containing different formulas, all cardioplegia solutions aim to minimize probable ischemia reperfusion injuries by providing cardiac depolarization and arrest with high concentrations of potassium. Del Nido cardioplegia (DNC) was first used in congenital cardiac surgery in the early 1990s[1]. It contains a base solution of a crystalloid component (Plasma-Lyte A, lidocaine, magnesium sulphate, potassium chloride, mannitol, sodium bicarbonate). Lidocaine is the main distinctive component of this formula It prolongs refractory period in myocytes and minimizes sodium and calcium passage into the cell

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