Background
Paediatric del Nido cardioplegia (DNC) has been tested in selected populations of
low-risk adult patients. This study examined its use in an unselected medium-to-high-risk
adult population and compared the results with a propensity-matched population that
received intermittent warm blood cardioplegia (IWBC).
Methods
Data from the last 1,000 consecutive adult patients who underwent a variety of surgical
procedures under cardioplegic arrest with the use of IWBC or DNC between 2016 and
2018 were propensity score matched on preoperative clinical and demographic variables.
Two (2) main populations were 102 patients who received DNC and another set of matched
102 patients from a total of 1,000 patients who received IWBC, along with a subgroup
with an ejection fraction (EF) ≤40% (EFDNC vs EFIWBC). Postoperative outcomes were
mortality, peak troponin T, postoperative EF%, and aortic cross-clamp time.
Results
There were no preoperative differences amongst the groups in the main cohort (Euroscore
II: DNC 4.1±8, IWBC 4.0±7; EF%: DNC 47±10, IWBC 47±11) and in the subgroup (EF%: EFDNC
32±6%, EFIWBC 32±6%; p=0.45). There were also no differences in three of the outcomes.
A significant postoperative improvement was noticed in the EF% in the DNC (32±6% 95%
CI 29-34 to 39±12 95% CI 34-44; p=0.001) in the EFDNC group.
Conclusions
This initial experience of del Nido cardioplegia proved to be effective in a variety
of challenging pathologies in adult populations.
Keywords
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Article info
Publication history
Published online: October 11, 2019
Accepted:
August 19,
2019
Received in revised form:
July 30,
2019
Received:
June 4,
2019
Identification
Copyright
© 2019 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
