Key result
Del Nido cardioplegia significantly reduced the incidence of post-operative arrhythmia (20% vs 34.29%, p=0.05) and required lower cardioplegia volume compared to conventional cardioplegia during CABG.
Why the study?
The study was conducted to compare early outcomes regarding myocardial protection between antegrade conventional crystalloid cardioplegia and Del Nido cardioplegia in patients undergoing CABG.
Does Del Nido cardioplegia improve early outcomes and myocardial protection compared to conventional cardioplegia in adult patients undergoing CABG?
RCT (n=140)
Lottery method
No
Does Del Nido cardioplegia improve early outcomes and myocardial protection compared to conventional cardioplegia in adult patients undergoing CABG?
Absolute Event Rate: 20% vs 34.29%
p-value: p=0.05
In adult patients undergoing CABG, Del Nido cardioplegia significantly reduces the required cardioplegia volume compared to conventional cardioplegia, though this study observed longer bypass times and higher rates of postoperative MI in the Del Nido group.
Caution against Del Nido cardioplegia in adult CABG due to higher MI; challenges assumptions of superior myocardial protection.
Objective: To compare early outcomes in antegrade conventional crystalloid cardioplegia with Del Nido (DN) cardioplegia in term of myocardial protection in patients undergoing CABG. Methodology: All the patients undergoing Coronary artery bypass grafting surgery were enrolled in this study after informed consent. Preoperative, intra-operative and postoperative variables were entered in the pre-designed proforma and patients were followed to compare early outcomes in Del-Nido versus Conventional Cardioplegia. Results: The mean age of the patients in Del Nido group was 54.61 ± 9.129 whereas the mean age of the patients in Conventional Cardioplegia group was 53.91 ± 10.39. There were 50(71.43%) males and 20(28.57%) females in Del-Nido group as compare with Conventional group 52(74.29%) males and 18(25.71%) females in this study. The mean cardioplegia volume given to Del Nido and Conventional Cardioplegia group as (1271.43 ± 447.91 vs 2142.86 ± 584.48 (ml/min) with p-value is <0.005 which shows there is a significant difference of Cardioplegia volume given to both groups. The mean cardiopulmonary bypass time (min) in Del Nido group was 116.87 ± 27.25 and in Conventional Cardioplegia group 106.58 ± 29.19 and the p-value of CPB time was significant 0.004. In our data 6(8.5%) patients from Del Nido Cardioplegia Group suffered from AKI whilst in Conventional Cardioplegia Group there were 7(10%) patients who suffered from AKI. Similarly 3(4.29%) patients from Del Nido Group and 2(2.86%) patients from conventional Cardioplegia Group previously suffered from stroke. Arrhythmia is a disorder of heart that affects the rate or rhythm at which the heart beats. Its p-value is significant (0.05) which shows there is a significant difference of this disorder in both groups Conclusion: There was a significant difference in post-operative complication Arrhythmia in both groups and the need for a lower cardioplegia volume and an uninterrupted procedure are the main advantages of Del Nido (DN) cardioplegia solution, which make it superior from conventional cardioplegia.
No takes yet. Share an insight, caveat, or question.
Rahim et al. (2021) conducted an RCT in Coronary Artery Disease requiring CABG (n=140). Del Nido Cardioplegia vs. Conventional Cardioplegia was evaluated on Post-operative arrhythmia (p=0.05). Del Nido cardioplegia significantly reduced the incidence of post-operative arrhythmia (20% vs 34.29%, p=0.05) and required lower cardioplegia volume compared to conventional cardioplegia during CABG.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: