PDF(Pubmed)
Abstract：
BACKGROUND: This study examined the efficacy of del Nido cardioplegia compared with traditional blood cardioplegia in adult cardiac surgery for isolated coronary artery bypass grafting by evaluating the early postoperative outcomes.
METHODS: A total of 119 patients who underwent isolated conventional coronary artery bypass grafting were enrolled and divided into two groups (del Nido cardioplegia group [n = 36] and blood cardioplegia group [n = 50]) based on the type of cardioplegia used. This study compared the preoperative characteristics, intraoperative data, and early postoperative outcomes. Further subgroup analyses were conducted for high-risk patient groups.
RESULTS: The 30-day mortality and morbidity rates were not significantly different between groups. The del Nido cardioplegia group exhibited advantageous myocardial protection outcomes, demonstrated by a significantly smaller rise in Troponin I levels post-surgery (2.8 [-0.4; 4.2] vs. 4.5 [2.9; 7.4] ng/mL, p = 0.004) and fewer defibrillation attempts during weaning off of cardiopulmonary bypass (0.0 ± 0.2 vs. 0.4 ± 1.1 times, p = 0.011) when compared to the blood cardioplegia group. Additionally, the del Nido group achieved a reduction in surgery duration, as evidenced by the reduced aortic cross-clamping time (64.0 [55.5; 75.5] vs. 77.5 [65.0; 91.0] min, p = 0.001) and total operative time (287.5 [270.0; 305.0] vs. 315.0 [285.0; 365.0] min, p = 0.008). Subgroup analyses consistently demonstrated that the del Nido cardioplegia group had a significantly smaller postoperative increase in Troponin I levels across all subgroups (p < 0.05).
CONCLUSIONS: del Nido cardioplegia provided myocardial protection and favorable early postoperative outcomes compared to blood cardioplegia, making it a viable option for conventional coronary artery bypass grafting. Establishing a consensus on the protocol for Del Nido cardioplegia administration in adult surgeries is needed.
METHODS: A total of 119 patients who underwent isolated conventional coronary artery bypass grafting were enrolled and divided into two groups (del Nido cardioplegia group [n = 36] and blood cardioplegia group [n = 50]) based on the type of cardioplegia used. This study compared the preoperative characteristics, intraoperative data, and early postoperative outcomes. Further subgroup analyses were conducted for high-risk patient groups.
RESULTS: The 30-day mortality and morbidity rates were not significantly different between groups. The del Nido cardioplegia group exhibited advantageous myocardial protection outcomes, demonstrated by a significantly smaller rise in Troponin I levels post-surgery (2.8 [-0.4; 4.2] vs. 4.5 [2.9; 7.4] ng/mL, p = 0.004) and fewer defibrillation attempts during weaning off of cardiopulmonary bypass (0.0 ± 0.2 vs. 0.4 ± 1.1 times, p = 0.011) when compared to the blood cardioplegia group. Additionally, the del Nido group achieved a reduction in surgery duration, as evidenced by the reduced aortic cross-clamping time (64.0 [55.5; 75.5] vs. 77.5 [65.0; 91.0] min, p = 0.001) and total operative time (287.5 [270.0; 305.0] vs. 315.0 [285.0; 365.0] min, p = 0.008). Subgroup analyses consistently demonstrated that the del Nido cardioplegia group had a significantly smaller postoperative increase in Troponin I levels across all subgroups (p < 0.05).
CONCLUSIONS: del Nido cardioplegia provided myocardial protection and favorable early postoperative outcomes compared to blood cardioplegia, making it a viable option for conventional coronary artery bypass grafting. Establishing a consensus on the protocol for Del Nido cardioplegia administration in adult surgeries is needed.
摘要：
背景：本研究通过评估术后早期结果，研究了在成人心脏手术中，与传统血液心脏停搏液相比，DelNido心脏停搏液的疗效。
方法：共119例接受单纯常规冠状动脉旁路移植术的患者，根据使用的心脏停搏液类型分为两组（DelNido心脏停搏液组[n=36]和血液心脏停搏液组[n=50]）。本研究比较了术前特点,术中数据,和术后早期结果。对高危患者组进行了进一步的亚组分析。
结果：两组间30天死亡率和发病率无显著差异。delNido心脏停搏液组表现出有利的心肌保护结果，手术后肌钙蛋白I水平的升高明显较小（2.8[-0.4;4.2]vs.4.5[2.9;7.4]ng/mL，p=0.004），体外循环断奶期间的除颤尝试较少（0.0±0.2vs.0.4±1.1倍，与血液心脏停搏液组相比，p=0.011）。此外,delNido组减少了手术时间，主动脉交叉钳夹时间减少（64.0[55.5;75.5]vs.77.5[65.0;91.0]分钟,p=0.001）和总手术时间（287.5[270.0;305.0]vs.315.0[285.0;365.0]min,p=0.008)。亚组分析一致表明，在所有亚组中，delNido心脏停搏组的术后肌钙蛋白I水平增加明显较小（p<0.05）。
结论：delNido心脏停搏液与血液心脏停搏液相比可提供心肌保护和良好的术后早期结局，使其成为常规冠状动脉旁路移植术的可行选择。需要就成人手术中DelNido心脏停搏液的给药方案达成共识。
方法：共119例接受单纯常规冠状动脉旁路移植术的患者，根据使用的心脏停搏液类型分为两组（DelNido心脏停搏液组[n=36]和血液心脏停搏液组[n=50]）。本研究比较了术前特点,术中数据,和术后早期结果。对高危患者组进行了进一步的亚组分析。
结果：两组间30天死亡率和发病率无显著差异。delNido心脏停搏液组表现出有利的心肌保护结果，手术后肌钙蛋白I水平的升高明显较小（2.8[-0.4;4.2]vs.4.5[2.9;7.4]ng/mL，p=0.004），体外循环断奶期间的除颤尝试较少（0.0±0.2vs.0.4±1.1倍，与血液心脏停搏液组相比，p=0.011）。此外,delNido组减少了手术时间，主动脉交叉钳夹时间减少（64.0[55.5;75.5]vs.77.5[65.0;91.0]分钟,p=0.001）和总手术时间（287.5[270.0;305.0]vs.315.0[285.0;365.0]min,p=0.008)。亚组分析一致表明，在所有亚组中，delNido心脏停搏组的术后肌钙蛋白I水平增加明显较小（p<0.05）。
结论：delNido心脏停搏液与血液心脏停搏液相比可提供心肌保护和良好的术后早期结局，使其成为常规冠状动脉旁路移植术的可行选择。需要就成人手术中DelNido心脏停搏液的给药方案达成共识。
