Key result
Del Nido cardioplegia resulted in similar early mortality compared to conventional blood cardioplegia in adults with reduced LVEF undergoing cardiac surgery (OR 0.94; 95% CI 0.52-1.71; p=0.822).
Why the study?
Research on the safety and efficacy of del Nido cardioplegia in adult patients with reduced LVEF is limited.
Does del Nido cardioplegia reduce early mortality or improve postoperative LVEF compared to conventional blood cardioplegia in adult patients with reduced LVEF undergoing cardiac surgery?
Meta-Analysis (n=1,160)
Does del Nido cardioplegia reduce early mortality or improve postoperative LVEF compared to conventional blood cardioplegia in adult patients with reduced LVEF undergoing cardiac surgery?
Odds Ratio: 0.94 (95% CI 0.52–1.71)
p-value: p=0.822
In adult patients with reduced LVEF undergoing cardiac surgery, del Nido cardioplegia provides comparable early mortality and morbidity to conventional blood cardioplegia, with potentially better preservation of postoperative myocardial function.
Comparable early outcomes support del Nido use in reduced-LVEF surgery; extends evidence to this high-risk cohort.
Purpose Research on the safety and efficacy of del Nido cardioplegia in adult patients with reduced left ventricular ejection fraction (LVEF) is limited. We evaluated the effect of del Nido cardioplegia on early outcomes of cardiac surgery in this cohort. Methods PubMed, Scopus, and the Cochrane Central Register of Controlled Trials were searched through August 2024 to conduct a meta-analysis comparing del Nido to other cardioplegia in adult patients with reduced LVEF (≤50%). Primary endpoint was early mortality, and secondary endpoints included morbidities, aortic cross-clamp time and postoperative LVEF before discharge. A random-effect model was used to estimate the pooled effect size. Results Seven studies met our eligibility criteria, including three propensity score-matched studies with a total of 1160 patients. Conventional blood cardioplegia was used exclusively as a control solution in the included studies. The incidence of early mortality was similar between the del Nido and control groups, with a pooled odds ratio of 0.94 [95% confidence interval: 0.52; 1.71] ( p = .822). Postoperative stroke ( p = .680), renal failure ( p = .832), atrial fibrillation ( p = .412), and aortic cross-clamp time ( p = .153) were also comparable between the two groups. Postoperative LVEF was significantly higher in the del Nido group compared to the control group, with a standardized mean difference of 0.52 [95% confidence interval: 0.07; 0.96] ( p = .034). Conclusions In adult patients with reduced LVEF undergoing cardiac surgery, del Nido cardioplegia provides comparable mortality and morbidity rates compared to conventional blood cardioplegic solutions, with the potential to offer protective effects on myocardial function.
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Yamashita et al. (2025) conducted a meta-analysis in Reduced left ventricular ejection fraction (LVEF) undergoing cardiac surgery (n=1,160). del Nido cardioplegia vs. Conventional blood cardioplegia was evaluated on early mortality (OR 0.94, 95% CI 0.52-1.71, p=0.822). Del Nido cardioplegia resulted in similar early mortality compared to conventional blood cardioplegia in adults with reduced LVEF undergoing cardiac surgery (OR 0.94; 95% CI 0.52-1.71; p=0.822).
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