The application of del Nido cardioplegia for myocardial protection in adult coronary artery bypass grafting: a cohort study

BACKGROUND: Del Nido cardioplegia is widely used in adult cardiopulmonary bypass surgery and has a satisfying cardioprotective effect for about 90 minutes by single dose, but the effect in patients with coronary heart disease remains confused. The purpose of this study was to examine the cardioprotective effect of del Nido cardioplegia in adult multivessel coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). METHODS: This retrospective comparative analysis included 124 consecutive patients undergoing isolated on-pump CABG performed by a single surgeon between January 2017 and December 2020. The demographic characteristics and medical history of the included patients were collected. The included patients were divided into two groups: a del Nido cardioplegia (DN) group and a conventional multidose blood cardioplegia (BC) group. Perioperative, intraoperative, and postoperative indicators and complications were compared. RESULTS: Compared with the BC group, CPB and aortic cross-clamp time were significantly shorter in the DN group. In the early postoperative period, the hemoglobin concentration in the DN group was significantly higher than that in the BC group (P<0.05). CONCLUSIONS: This study demonstrated that the application of del Nido cardioplegia in adult on-pump CABG could lead to a significantly shorter aortic cross-clamp and CPB time, as well as a higher hemoglobin concentration in the early postoperative period. The myocardial protective effect of del Nido cardioplegia is not inferior to that of conventional blood perfusion in adult on-pump CABG.