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OBJECTIVE: We compared early results including myocardial troponin level and clinical outcomes after adult cardiovascular surgery using del Nido and blood cardioplegia.
METHODS: 140 patients(59±14years) who underwent cardiovascular surgery using del Nido(DN group, n=38) or blood(BC group, n=102) cardioplegia were enrolled. Propensity score analyses were performed and the levels of troponin I(TnI) and early clinical outcomes in the 2 groups were compared.
RESULTS: In the DN group, cardioplegia was infused with an initial dose of 1127±224mL, and an additional 500mL was reinfused in 12 patients 92.2min after initial infusion. In the BC group, the number of infusions and infused volumes were 4.0±1.6 and 2746±1220mL, respectively. After release of aortic cross clamp(ACC), spontaneous defibrillation was achieved more frequently in the DN than BC groups(34/38 vs 26/102, p<0.001). The peak TnI levels after surgery were 10.2(2.0-90.2) and 17.8(3.5-153.9)ng/mL in the DN and BC groups, respectively. There were no differences in the peak level and serial changes of TnI between the 2 groups(p=0.802). In the DN group, ACC time was not associated with the peak TnI level. In the BC group, however, ACC time was a significant factor associated with peak TnI after surgery(p<0.001). There were no significant differences in early mortality(n=3) and postoperative complication rates between the 2 groups. Propensity score matching extracted 30 pairs. The levels of TnI and clinical outcomes were similar between the 2 propensity score-matched groups.
CONCLUSIONS: Del Nido cardioplegia is as effective as blood cardioplegia for adult patients in terms of myocardial protection and early clinical outcomes, and its single-dose and small-volume properties might be beneficial in minimally invasive adult cardiac surgeries.