Del nido cardioplegia in adults: a retrospective observational study in comparison to modified St. Thomas cardioplegia in cardiac surgery

J Cardiothorac Surg. 2024 Apr 25;19(1):266. doi: 10.1186/s13019-024-02683-1.

Abstract

Background: St. Thomas cardioplegia is commonly administered to adults, yet repeated dosing at brief intervals is required. Del Nido's cardioplegic solution provides a prolonged duration of safe myocardial arrest, yet it was primarily intended for pediatric cardiac surgery. Recently, there has been an increasing interest in using Del Nido's in adults; this might be due to its ease of administration and extended re-dosing intervals. This study contrasted Del Nido's to modified St. Thomas cardioplegia in adults.

Methods: This study was conducted on 200 patients. Troponin-T was the primary outcome within the first 24 and 48 h post-surgery. Cardiopulmonary bypass time, cross-clamp time, intraoperative use of inotropic support, defibrillator and/or intra-aortic balloon were the secondary outcomes of the study.

Results: There was a significant reduction in post-operative Troponin-T levels in the first 24 and 48 h within Del Nido's group compared to the modified St. Thomas group. The cross-clamp and cardiopulmonary bypass times were also found to be lower within Del Nido's group.

Conclusion: This study has demonstrated a significant reduction in early postoperative Troponin-T levels as well as operative times favoring Del Nido's in adults.

Keywords: Cardiac surgery methods; Cardioplegia; Del Nido; Modified St Thomas.

Publication types

  • Observational Study
  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Bicarbonates
  • Calcium Chloride
  • Cardiac Surgical Procedures* / methods
  • Cardioplegic Solutions*
  • Cardiopulmonary Bypass / methods
  • Electrolytes*
  • Female
  • Heart Arrest, Induced* / methods
  • Humans
  • Lidocaine*
  • Magnesium
  • Magnesium Sulfate*
  • Male
  • Mannitol*
  • Middle Aged
  • Potassium Chloride
  • Retrospective Studies
  • Sodium Bicarbonate*
  • Sodium Chloride
  • Solutions*
  • Treatment Outcome
  • Troponin T* / blood

Substances

  • Cardioplegic Solutions
  • Troponin T
  • Del Nido cardioplegia solution
  • Potassium Chloride
  • St. Thomas' Hospital cardioplegic solution
  • Mannitol
  • Sodium Bicarbonate
  • Bicarbonates
  • Solutions
  • Magnesium Sulfate
  • Calcium Chloride
  • Lidocaine
  • Electrolytes
  • Sodium Chloride
  • Magnesium