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).
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.
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.
This initial experience of del Nido cardioplegia proved to be effective in a variety of challenging pathologies in adult populations.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Heart, Lung and Circulation
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- History and use of del Nido cardioplegia solution at Boston Children's Hospital.J Extra Corpor Technol. 2012; 44 (Erratum in: J Extra Corpor Technol 2013;45(4):262): 98-103
- Utilization of del Nido cardioplegia in adult coronary artery bypass grafting a retrospective analysis.Circ J. 2019; 83: 342-346
- Del Nido cardioplegia-not just kids stuff.J Extra Corpor Technol. 2016; 48: 25-28
- Use of del Nido cardioplegia in adult cardiac surgery.Thorac Cardiovasc Surg. 2015; 63: 624-627
- Propensity matched analysis of del Nido cardioplegia in adult coronary artery bypass grafting: initial experience with 100 consecutive patients.Ann Thorac Surg. 2016; 101: 2237-2241
- Del Nido versus Buckberg cardioplegia in adult isolated valve surgery.J Thorac Cardiovasc Surg. 2015; 149 (discussion 634–6): 626-634
- Comparison of del Nido and intermittent warm blood cardioplegia in coronary artery bypass grafting surgery.Ann Thorac Cardiovasc Surg. 2019; 25: 39-45
- The use of del Nido cardioplegia in adult cardiac surgery: A prospective randomized trial.J Thorac Cardiovasc Surg. 2018; 155: 1011-1018
- Intermittent antegrade warm blood cardioplegia.Ann Thor Surg. 1999; 58: 398-402
- Use of del Nido cardioplegia for adult cardiac surgery at the Cleveland Clinic: Perfusion implications.J Extra Corpor Technol. 2014; 46: 317-323
- Sample Size Calculations in Clinical Research.2nd Ed. Chapman & Hall/CRC, London UK2008: 61
- Short-term outcomes in adult cardiac surgery in the use of del Nido cardioplegia solution.Perfusion. 2016; 31: 27-33
- Myocardial protection using del Nido cardioplegia solution in adult reoperative aortic valve surgery.J Card Surg. 2014; 29: 445-449
- Custodiol for myocardial protection a preservation: a systematic review.Ann Cardiothorac Surg. 2013; 2: 717-728
- Del Nido Cardioplegia can be safely administered in high-risk coronary artery bypass grafting surgery after acute myocardial infarction: a propensity matched comparison.J Cardiothorac Surg. 2014; 9: 141
- Del Nido cardioplegia: A one stop shot for adult cardiac surgery?.J Thorac Cardiovasc Surg. 2018; 155: 1019-1020
- Del Nido cardioplegia: Passing fad or here to stay?.J Thorac Cardiovasc Surg. 2018; 155: 1009-1010
- Pro: In favor of more generalized use of del Nido cardioplegia in adult patients undergoing cardiac surgery.J Cardiothorac Vasc Anesth. 2018; 33
- Del Nido cardioplegia in adult cardiac surgery: Beyond single-valve surgery.Interact Cardiovasc Thorac Surg. 2018; 27: 81-87
- Del Nido cardioplegia for myocardial protection in adult cardiac surgery: A systematic review and meta-analysis.ASAIO J. 2018; 64: 360-367
Published online: October 11, 2019
Accepted: August 19, 2019
Received in revised form: July 30, 2019
Received: June 4, 2019
© 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.