To Evaluate The Effectiveness Of Del Nido Cardioplegia In Adult Cardiac Surgery At A Tertiary Care Centre

Abstract

el Nido cardioplegia has emerged as a promising myocardial protector in adult open heart surgeries after it's initial success in Paediatric open heart surgeries, specially in immature myocardiums. To conclude, del Nido as an effective cardioplegic agent among the adult open heart surgeries one must compare it's advantages and disadvantages with other cardioplegic agents.

Methodology

This is a retrospective study where about 200 patients were studied who were adults with first time CABG, Valve Surgery, interventions for Aneurysms etc requiring CPB. After obtaining the institutional ethical committee approval the study was conducted. Primary outcomes were assessed for spontaneous cardiac rhythm, requirement of Shocks( defibrillatory) Troponin levels compared with baseline, after 1,2 hours after the CPB (pump off), ventilatory duration, length of ICU stay, requirement of Insulin, glycaemic indices, overall hospital stay, mortality etc several of these factors were  studied.

Results

Pre-operative criteria were almost similar between groups including age, society of thoracic surgeons risk score, for CABG and valve procedures

There was no significant difference on CPB time (98 vs 104 minutes) and cross clamp time(68 vs 79.8 minutes: p=0.019).

The Del Nido group showed higher return to spontaneous rhythm(97. 8%  vs 81.7%

p= 0. 022 and fewer patients required inotropic support (65.1% vs84. 32%) but did not reach the statistical significance.

Conclusions

From this study it may be inferred that del Nido cardioplegia may be used safely for adult cardiac surgeries with streamlined surgical workflow. Troponin should be checked baseline and at time bound manner to prove the Superiority of the cardioplegia.