BACKGROUND AND AIMS: The immediate postischemic period is marked by elevated intracellular calcium levels, which can lead to irreversible myocyte injury. Del Nido cardioplegia was developed for use in the pediatric population to address the inability of immature myocardium to tolerate high levels of intracellular calcium following cardiac surgery. Our aim in this study is to determine if this solution can be used safely and effectively in an adult, reoperative population. METHODS: All patients undergoing isolated reoperative aortic valve replacement at our institution from 2010 to 2012 were retrospectively reviewed. Demographics, comorbidities, operative variables, postoperative complications, and patient outcomes were collected. Patients were divided into two groups based on cardioplegia strategy used: whole blood cardioplegia (WB, n = 61) and del Nido cardioplegia (DN, n = 52). RESULTS: Mean age in the study was 73.4 ± 14.3 years and 86 patients were male (76.1%). Eighty-four patients had undergone prior coronary artery bypass graft (CABG) (74.3%). Patients in the DN group required significantly lower total volume of cardioplegia (1147.6 ± 447.2 mL DN vs. 1985.4 ± 691.1 mL WB, p < 0.001) and retrograde cardioplegia dose (279.3 ± 445.1 mL DN vs. 1341.2 ± 690.8 mL WB, p < 0.001). There were no differences in cross-clamp time, bypass time, postoperative complication rate, or patient outcomes between groups. CONCLUSIONS: Del Nido cardioplegia use in an adult, reoperative aortic valve population offers equivalent postoperative outcomes when compared with whole blood cardioplegia. In addition, use of del Nido solution requires lower total and retrograde cardioplegia volumes in order to achieve adequate myocardial protection.
BACKGROUND AND AIMS: The immediate postischemic period is marked by elevated intracellular calcium levels, which can lead to irreversible myocyte injury. Del Nido cardioplegia was developed for use in the pediatric population to address the inability of immature myocardium to tolerate high levels of intracellular calcium following cardiac surgery. Our aim in this study is to determine if this solution can be used safely and effectively in an adult, reoperative population. METHODS: All patients undergoing isolated reoperative aortic valve replacement at our institution from 2010 to 2012 were retrospectively reviewed. Demographics, comorbidities, operative variables, postoperative complications, and patient outcomes were collected. Patients were divided into two groups based on cardioplegia strategy used: whole blood cardioplegia (WB, n = 61) and del Nido cardioplegia (DN, n = 52). RESULTS: Mean age in the study was 73.4 ± 14.3 years and 86 patients were male (76.1%). Eighty-four patients had undergone prior coronary artery bypass graft (CABG) (74.3%). Patients in the DN group required significantly lower total volume of cardioplegia (1147.6 ± 447.2 mL DN vs. 1985.4 ± 691.1 mL WB, p < 0.001) and retrograde cardioplegia dose (279.3 ± 445.1 mL DN vs. 1341.2 ± 690.8 mL WB, p < 0.001). There were no differences in cross-clamp time, bypass time, postoperative complication rate, or patient outcomes between groups. CONCLUSIONS:Del Nido cardioplegia use in an adult, reoperative aortic valve population offers equivalent postoperative outcomes when compared with whole blood cardioplegia. In addition, use of del Nido solution requires lower total and retrograde cardioplegia volumes in order to achieve adequate myocardial protection.
Authors: John G Byrne; Alexandros N Karavas; Farzan Filsoufi; Tomislav Mihaljevic; Lishan Aklog; David H Adams; Lawrence H Cohn; Sary F Aranki Journal: Ann Thorac Surg Date: 2002-03 Impact factor: 4.330
Authors: Yeong-Hoon Choi; Douglas B Cowan; Thorsten C W Wahlers; Roland Hetzer; Pedro J Del Nido; Christof Stamm Journal: Eur J Cardiothorac Surg Date: 2009-07-17 Impact factor: 4.191
Authors: J Darcy O'Brien; Susan E Howlett; Hayley J Burton; Stacey B O'Blenes; D Sharon Litz; Camille L Hancock Friesen Journal: Ann Thorac Surg Date: 2009-05 Impact factor: 4.330
Authors: Goh Si Guim; Cindy Goh Wah Hoon; Clara Anne Lim; Huang Shoo Chay-Nancy; Ashlynn Ai Li Ler; Qi Xuan Lim; Nurdiyana Binte Jaafar; Cheryl Lim; Faizus Sazzad; Theo Kofidis Journal: J Extra Corpor Technol Date: 2020-12
Authors: Donald S Likosky; Xiaoting Wu; David C Fitzgerald; Jonathan W Haft; Gaetano Paone; Matthew A Romano; Joshua B Goldberg; Alphonse DeLucia; David L Sturmer; David M Grix; Donald H Nieter; Brittney N Graebner; Timothy A Dickinson Journal: J Extra Corpor Technol Date: 2020-09
Authors: Niv Ad; Sari D Holmes; Paul S Massimiano; Anthony J Rongione; Lisa M Fornaresio; David Fitzgerald Journal: J Thorac Cardiovasc Surg Date: 2017-11-13 Impact factor: 5.209
Authors: Marc Najjar; Isaac George; Hirokazu Akashi; Takashi Nishimura; Halit Yerebakan; Linda Mongero; James Beck; Stephen C Hill; Hiroo Takayama; Mathew R Williams Journal: J Cardiothorac Surg Date: 2015-11-26 Impact factor: 1.637