Single Dose of Del Nido Cardioplegic Solution in Comparison with St Thomas Hospital Solution in Mitral Valve Surgery: A Propensity Matched Comparison

Zwoliński R, Jaszewski R, Jander S, Zagórski M, Adamek-Kośmider A, Bednarski I and Krejca M

Department of Cardiac Surgery, Medical University of Lodz, Poland

^*Correspondance to: Radoslaw Zwolinski 

 PDF  Full Text DOI: 10.25107/2474-1647.2467

Abstract

Background: The aim of the study was to compare efficacy and safety of use of a single dose of Del Nido Cardioplegic solution (DN) and repeated doses of St. Thomas Hospital II cardioplegic solution (ST) in the group of patients operated due to mitral valve defect as a single or complex cardiac procedure.
Methods: The study was performed between 11/2014 and 02/2018. All 117 consecutive procedures were performed by a single surgeon. Of these first 53 patients (ST group) were given ST solution and the rest 64 patients (DN group) received DN cardioplegy. The ST group was operated between 11/2014 and 10/2016 and the DN Group between 10/2016 and 02/2018. Propensity score matching was performed using logistic regression model with Hooke-Jeeves algorithm.
Results: The patients from the ST group had higher morbidity in comparison to the DN group (Euroscore II 8.3 vs. 3.3) before and after matching. The patients from the DN group had significantly shorter times of operation, aorta cross-clamping, anesthesia and Extracorporeal Circulation (ECC). Also postoperative troponin levels were lower in this group; however, the difference did not reach a level of statistical significance. In the DN group a rate of defibrillation after aorta de-clamping was lower comparing with the ST group, however, a rate of temporary heart pacing was higher.
Conclusion: Del Nido Cardioplegic solution can be used effectively and safety in comparison with St Thomas II in adult mitral valve surgery performed as a single or complex cardiac procedures. A single dose of DN allows decreasing surgery, aorta cross-clamping and ECC times what yields lower postoperative tropine levels. The use of a single dose of DN compared with repeated doses of ST due to lower crystalloid load results with decreased hemodilution effect what is reflected in significantly higher hemoglobin concentration both during the operation and postoperatively. This is followed by lower rate of intraoperative hemoconcentration use, as well as postoperative red cells transfusions. However, the last two effects were not statistically significant.

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Cite the article

Zwoli?ski R, Jaszewski R, Jander S, Zag�rski M, Adamek-Ko?mider A, Bednarski I, et al. Single Dose of Del Nido Cardioplegic Solution in Comparison with St Thomas Hospital Solution in Mitral Valve Surgery: A Propensity Matched Comparison. Clin Surg. 2019; 4: 2467.