Clinical, biochemical and histological indicators of Del Nido cardioplegia efficacy in patients with severe myocardial hypertrophy

To evaluate the effectiveness of two cardioplegia techniques in patients with severe myocardial hypertrophy undergoing septal myectomy or aortic valve replacement. A comparative pilot prospective single-center randomized study included 46 patients between 2022 and 2023. Patients were randomized into...

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Published inHirurgija (Moskva) no. 12; p. 59
Main Authors Belov, Yu V, Lysenko, A V, Akselrod, B A, Kulinchenko, O S, Lednev, P V, Salagaev, G I, Solovyova, S E, Ivanova, A G
Format Journal Article
LanguageEnglish
Russian
Published Russia (Federation) 2023
Subjects
Cardioplegic Solutions - adverse effects
Heart Arrest, Induced - adverse effects
Heart Arrest, Induced - methods
Humans
Hypertrophy
Prospective Studies
Retrospective Studies
Troponin I
myocardial protection
myocardial hypertrophy
cardioplegia
del Nido
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Summary:To evaluate the effectiveness of two cardioplegia techniques in patients with severe myocardial hypertrophy undergoing septal myectomy or aortic valve replacement. A comparative pilot prospective single-center randomized study included 46 patients between 2022 and 2023. Patients were randomized into 2 groups: Del Nido ( =23) and Custodiol ( =23). We analyzed perioperative echocardiography data, troponin I at several time points, perioperative complications and histological data. Both groups were comparable in time of myocardial ischemia, cardiopulmonary bypass, duration of anesthesia and surgery ( >0.05). The maximum ischemia time in the Del Nido group was 84 min. The same group showed significantly higher percentage of spontaneous rhythm recovery (65.2% vs. 30%, =0.008). None patient required mechanical support, high-dose inotropes or vasopressors. Troponin I in 2 hours after cardiopulmonary bypass ( =0.415), 12 ( =0.528) and 24 hours after admission to the intensive care unit ( =0.281) were similar in both groups. No significant difference was found in ventilation time, ICU- and hospital-stay. Del Nido cardioplegia has some advantages compared to Custodiol and does not lead to perioperative complications in case of aortic cross-clamping time <90 min in patients with myocardial hypertrophy.
ISSN:0023-1207
DOI:10.17116/hirurgia202312159