Multi-organ protective effects of del Nido cardioplegia in adult cardiac valve surgery
Objective To compare the myocardial protective effects and impacts on the lungs and kidneys between del Nido cardioplegia(DNC)and traditional 4∶1 cold blood cardioplegia(CBC)in adult cardiac valve replacement surgery.Methods A retrospective analysis was conducted on 60 adult patients who underwent cardiac valve surgery with cardiopulmonary by-pass(CPB)between August 2021 and August 2022 at our hospital.The patients were divided into two groups:DNC group(n=32)and CBC group(n=28).The levels of cardiac troponin I(cTnl),creatine kinase MB(CKMB),creatinine,blood urea nitrogen(BUN),partial pres-sure of oxygen(PO2),partial pressure of carbon dioxide(PCO2),and other indicators were compared between the two groups at pre-operation(T0),1-hour post-operation(T1),and 24 hours post-operation(T2).Results There were no significant differences in cTnI,CKMB,creatinine,BUN,PO2,PCO2,surgical mortality rate,complication rate,and other indicators between the two groups.The total usage of cardioplegia solution,CPB time,and aortic cross-clamp time were significantly lower in the DNC group compared to the CBC group(P＜0.05).Among patients with low body weight(≤55 kg),the DNC group required higher blood transfu-sion volumes than the CBC group(P＜0.05).Conclusion DNC and CBC have similar myo-cardial protective effects and are suitable for cardiac valve replacement surgery.They can re-duce cross-clamp and bypass times without affecting lung and kidney functions.However,for anemic or low body weight patients,strategies such as reduced priming or modified ultrafiltra-tion should be considered to mitigate the effects of blood dilution caused by DNC.
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