BACKGROUND The del Nido cardioplegia was devised and introduced as a single dose cardioplegia for myocardial protection in congenital heart surgery by Petro del Nido and team. The most commonly used cardioplegia in adult cardiac surgery was multidose blood cardioplegia which has to be repeated every 25 to 30 minutes to maintain cardiac arrest. For this, the surgery has to be interrupted leading to prolonged cardiopulmonary bypass and aortic cross clamp time. With promising results of del Nido cardioplegia in adult cardiac surgery, more and more centres adopted this single dose cardioplegia in adult cardiac surgery. We retrospectively analysed the safety and efficacy of del Nido cardioplegia and compared them with those of conventional blood cardioplegia in isolated coronary artery bypass surgery. METHODS We have been using multidose conventional blood cardioplegia (CBCP) solution for all our cardiac surgeries. We changed the cardioplegia protocol to single dose del Nido cardioplegia (DNCP) solution in October 2016. We collected the preoperative, intraoperative and post-operative data of 100 patients in each group, who underwent elective isolated coronary artery bypass surgery. RESULTS The baseline demographic features, pre- and post-operative cardiac function, number of coronary arteries involved, and comorbidities were similar in both groups. There was a statistically significant reduction in cardiopulmonary bypass time (77.16 ± 13.13 minutes vs. 121.69 ± 28.18 minutes, P-value < .00001) and aortic cross clamp time (57.71 ± 10.6 minutes vs. 77.26 ± 20.29 minutes, p value < .00001) in the DNCP group. The total dose of cardioplegia solution required was significantly less in DNCP group (1000 mL vs. 2393.56 ± 592.42 mL, P-value < .00001). The mean post-operative hospital stay in DNCP group was 7.87 ± 1.25 days as compared to 12.49 ± 1.29 days in CBCP group with a P-value < .00001. CONCLUSIONS The del Nido cardioplegia solution is associated with shorter cardiopulmonary bypass and aortic cross clamp time, less volume of cardioplegia solution and shorter mean hospital stay. The del Nido cardioplegia can be used in adult cardiac surgery with the same safety of conventional blood cardioplegia in adult isolated coronary artery bypass surgery. KEYWORDS Del Nido Cardioplegia, Isolated Coronary Artery Bypass Surgery, Myocardial Protection, Cardiopulmonary Bypass Time, Aortic Cross Clamp Time
Intermittent antegrade hyperkalaemic warm blood cardioplegia supplemented with magnesium prevents myocardial substrate derangement in patients undergoing coronary artery bypass surgery