Key result
Del Nido cardioplegia linked to ~77% less post-unclamping VF vs blood cardioplegia in minimally invasive AVR.
Why the study?
Experience with del Nido cardioplegia in minimally invasive aortic valve surgery was reported to evaluate its safety and myocardial protection compared to standard blood cardioplegia.
Does del Nido cardioplegia improve myocardial protection and reduce complications compared to standard blood cardioplegia in patients undergoing minimally invasive aortic valve replacement?
Cohort (n=46)
Does del Nido cardioplegia improve myocardial protection and reduce complications compared to standard blood cardioplegia in patients undergoing minimally invasive aortic valve replacement?
Absolute Event Rate: 12% vs 52%
p-value: p=0.004
Del Nido cardioplegia is safe and provides equivalent or better myocardial protection with less ventricular fibrillation and lower insulin requirements compared to standard blood cardioplegia in minimally invasive aortic valve replacement.
Supports further evaluation of del Nido in minimally invasive AVR; leaves open superiority for myocardial protection pending randomized trials.
The purpose of this study is to report our experience with del Nido cardioplegia (DNC) in the setting of minimally invasive aortic valve surgery. Forty-six consecutive patients underwent minimally invasive aortic valve replacement (AVR) through a "J" ministernotomy: twenty-five patients received the DNC (Group 1) and 21 patients received standard blood cardioplegia (SBC) (Group 2). The rate of ventricular fibrillation at unclamping was significantly lower in the DNC group (12% vs 52%, p=0.004), as well as postoperative creatinine kinase-MB (CK-MB) values (11.4±5.2 vs 17.7±6.9 µg/L, p=0.004). There were no deaths, myocardial infarctions or major complications in either group. Less postoperative use of intravenous insulin (28% vs 81%, p<0.001) was registered in the DNC group. In conclusion, the DNC is easy to use and safe during minimally invasive AVR, providing a myocardial protection at least equivalent to our SBC, improved surgical efficiency, minimal cost and less blood glucose perturbations.
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Vistarini et al. (2016) conducted a cohort in Minimally invasive aortic valve surgery (n=46). del Nido cardioplegia (DNC) vs. Standard blood cardioplegia (SBC) was evaluated on Ventricular fibrillation at unclamping (p=0.004). Del Nido cardioplegia during minimally invasive AVR was associated with lower ventricular fibrillation at unclamping compared to standard blood cardioplegia (12% vs 52%, p=0.004).
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