Del Nido cardioplegia in adult cardiac surgery: Clinical outcomes in a single center all-comer study.

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Perfusion-Uk Pub Date : 2024-11-01 Epub Date: 2023-11-09 DOI:10.1177/02676591231211492

Lorenzo Di Bacco, Fabrizio Rosati, Alberto Repossini, Massimo Baudo, Mauro Renghini, Debora Maddinelli, Francesca Boldini, Francesca Zanin, Cesare Tomasi, Claudio Muneretto, Stefano Benussi

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引用次数: 0

Abstract

Introduction: The use of Del Nido Cardioplegia (DNC) has been extended in the latest years from pediatrics to adult cardiac surgery with encouraging results. We sought to investigate clinical and biochemical outcomes in adult patients who underwent cardiac surgery with different degrees of complexity who received DNC for myocardial protection.

Methods: Data on one-thousand patients were retrospectively collected from 2020 to 2022. The only exclusion criteria was off-pump adult cardiac surgery. Surgical procedures weight was categorized according EuroSCORE II in six groups: Single-CABG(G1), isolated non-CABG(mitral) (G2), isolated non-CABG(aortic) (G3), isolated non-CABG(any) (G4), 2-procedures(G5), 3/more-procedures(G6). Primary endpoint was to identify a binomial correlation between hs-TnT/CK-MB and the cross-clamp time (X-Clamp). A secondary endpoint was the comparison between the treatment groups of the vasoactive-inotropic score (VIS) and the need of mechanical circulatory support (MCS).

Results: A linear correlation was identified between hs-TnT and X-clamp in the overall population (rho:0.447, p< .001) and in the treatment groups (G1:rho=0.357, p< .001/G2:rho=0.455, p< .001/G3:rho=0.307, p= .001/G4:rho=0.165, p= .257/G5:rho=0.157, p= .031/G6:rho=0.226, p= .015). Similarly, a linear correlation between CK-MB and X-clamp in the overall population (rho=0.457, p< .001) and treatment group (G1:rho=0.282, p< .001/G2:rho=0.287, p= .025/G3:rho=0.211, p= .009/G4:rho=0.0878, p= .548/G5:rho=0.309, p< .001/G6: rho=0.212, p= .024) was identified. As regard for the secondary endpoint, no differences were reported between the treatment groups in terms of VIS and MCS (VIS G1:7; G2:4; G3:7; G4:7, G5:5.5, G6:6, p-value= .691) (MCS G1: 4.5%; G2:4.8%; G3:3.3%; G4:3.1%; G5:1.4%; G6:5.3%; p-value= .372).

Conclusions: Del Nido Cardioplegia is a safe and useful tool in adult cardiac surgery allowing operators to achieve a stable and durable cardioplegic arrest. Despite accounting with different types of surgery, the six subgroups of our study population showed similar perioperative results.

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Del Nido心脏停搏液在成人心脏手术中的应用：单中心全角研究的临床结果。

引言：近年来，Del Nido心脏麻痹症（DNC）的使用已从儿科扩展到成人心脏手术，取得了令人鼓舞的结果。我们试图调查接受不同复杂程度心脏手术并接受DNC心肌保护的成年患者的临床和生化结果。方法：回顾性收集2020年至2022年1000例患者的资料。唯一的排除标准是非体外循环成人心脏手术。根据EuroSCORE II将手术重量分为六组：单次冠状动脉旁路移植术（G1）、孤立非冠状动脉旁路植入术（二尖瓣）（G2）、孤立无冠状动脉旁路切除术（主动脉）（G3）、孤立未经冠状动脉旁路接入术（任何）（G4）、两次手术（G5）和三次以上手术（G6）。主要终点是确定hs-TnT/CK-MB与交叉钳位时间（X-clamp）之间的二项式相关性。次要终点是两个治疗组的血管活性肌力评分（VIS）和机械循环支持需求（MCS）的比较。结果：在整个人群中（rho:0.447，p<.001）和治疗组中，hs-TnT和X-clamp之间存在线性相关性（G1:rho=0.357，p<.001/G2:rho=0.455，p<.001/G3:rho=0.307，p=.001/G4:rho=0.165，p=.257/G5:rho0.157，p=.031/G6：rho=0.226，p=.015）。类似地，在总体人群（rho=0.457，p<.001）和治疗组（G1:rho=0.282，p<.001/G2:rho0.287，p=.025/G3:rho0.211，p=.009/G4:rho0.0878，p=.548/G5:rho0.309，p<0.001/G6:rho0.212，p=.024）中，CK-MB和X-箝位之间存在线性相关性。关于次要端点，在VIS和MCS方面，治疗组之间没有差异（VIS G1:7；G2:4；G3:7；G4:7，G5:5.5，G6:6，p值=0.691）（MCS G1:4.5%；G2:4.8%；G3:3.3%；G4:3.1%；G5:1.4%；G6:5.3%；p值=0.372）。尽管考虑了不同类型的手术，但我们研究人群的六个亚组显示出相似的围手术期结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Perfusion-Uk 医学-外周血管病

CiteScore

3.00

自引率

8.30%

发文量

203

审稿时长

6-12 weeks

期刊介绍： Perfusion is an ISI-ranked, peer-reviewed scholarly journal, which provides current information on all aspects of perfusion, oxygenation and biocompatibility and their use in modern cardiac surgery. The journal is at the forefront of international research and development and presents an appropriately multidisciplinary approach to perfusion science.