Protective Efficacy on Adult Ischemic Myocardium under Bypass: Del Nido vs. St. Thomas Blood Cardioplegia.

Abstract

Purpose: To compare the myocardial protective efficacy of del Nido cardioplegia (DNC) with St. Thomas blood cardioplegia (SBC) in adult cardiac surgery.

Methods: From January to December 2021, all the patients who underwent elective cardiac operation were randomly divided into two cohorts based on the type of cardioplegia: DNC group and SBC group. Three categories of variables were compared: patient demographics, clinical variables, and laboratory variables.

Results: A total of 133 patients were enrolled in this study: DNC group, n = 65; and SBC group, n = 68. Except that the volume of cardioplegia administration were obvious less in the DNC group (P <0.01), no significant difference was found in the other postoperative clinical variables (P >0.05). No statistical significance was proved (P >0.05) in postoperative troponin I, creatine kinase, and B-type natriuretic peptide. The malondialdehyde concentration was higher in the SBC group, whether it is at 4 hours (P <0.05) or 24 hours (P >0.05) after operation. At the same two points in time, the change in superoxide dismutase activity was more significant in the SBC group (P <0.05).

Conclusion: The DNC cardioplegia was safe and effective on adult myocardium protection. The potential antioxidant stress effect in DNC may provide a direction for further improvement on the formula of cardioplegic solution.