Key result
Del Nido cardioplegia resulted in shorter surgical time but similar ICU stay compared to beating heart surgery, while beating heart surgery had lower post-operative troponin release.
Why the study?
Both Del Nido cardioplegia and beating heart valvular surgery are used in chronic mitral valve incompetence with left ventricular impairment, but their outcomes had not been directly compared.
Does Del Nido cardioplegia improve surgical outcomes compared to beating heart surgery in patients undergoing mitral valve replacement for chronic severe mitral incompetence with left ventricular impairment?
RCT (n=60)
randomized
No
Does Del Nido cardioplegia improve surgical outcomes compared to beating heart surgery in patients undergoing mitral valve replacement for chronic severe mitral incompetence with left ventricular impairment?
Del Nido cardioplegia is a safe and effective alternative to beating heart surgery for myocardial protection during mitral valve replacement in patients with left ventricular impairment, offering shorter surgical times.
Answers are grounded in this paper and cite their sources.
May guide cardioplegia selection in MVR with LV impairment; leaves open optimal approach pending larger RCTs.
Introduction: Del Nido cardioplegia is widely used nowadays in adult cardiac surgery. Beating heart valvular surgery is gaining more popularity and used by many cardiac centers nowadays. Both is used currently in cases of chronic mitral valve incompetence with left ventricle impairment.Aim of the work: To compare the outcome of Del Nido cardioplegia and beating surgery in cases of mitral valve replacement and left ventricular impairement.Patients and methods: This is a clinically randomized trial conducted in National Heart Institute during the period from June 2020 till December 2021. It contains sixty patients with chronic severe mitral incompetence indicated for isolated mitral valve replacement using two different modalities of myocardial protection. Patients were divided into two groups: group (A) containing 30 patients receiving Del Nido (ND) cardioplegia , and group (B) containing also 30 patients underwent mitral valve replacement through beating heart surgery.Results: Del Nido cardioplegia has a shorter surgical time than beating heart surgery, yet it has the same ventilation time , intensive care unit stay and need for inotropic support during weaning from bypass. Beating heart surgery had a lower level of post operative troponin release.Conclusion: Del Nido cardioplegia is a safe and effective method of myocardial protection during mitral valve replacement with left ventricular impairement.
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Saleh et al. (2022) conducted an RCT in Chronic severe mitral incompetence with left ventricular impairment (n=60). Del Nido cardioplegia vs. On-pump beating heart surgery was evaluated on Surgical time, ventilation time, intensive care unit stay, need for inotropic support, and post-operative troponin release. Del Nido cardioplegia resulted in shorter surgical time but similar ICU stay compared to beating heart surgery, while beating heart surgery had lower post-operative troponin release.
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