Abstract

Cardioplegia remains an essential component of myocardial protection during cardiac surgeries. Main purpose- This is a single centre prospective study that compares the better cardioprotective effect between del Nido(DN) and modified St. Thomas(mST) cardioplegia solution during intra-operative and immediate post-operative period. Method- This is a prospective randomised double blind study conducted over a period of one year from among the patients admitted for different cardiac surgeries. The selected patients were divided into two groups. Surgical procedures included in this study: coronary artery bypass graft(CABG)(multiple graft), mitral valve repair / replacement+ tricuspid ring annuloplasty ( MVR+TVR), mitral + aortic valve replacement (DVR), ventricular septal defect(VSD) repair, intra-cardiac repair for Tetralogy of Fallot (TOF). Surgical procedures excluded in this study were: isolated mitral valve replacement, aortic valve replacement (AVR), atrial septal defect (ASD), CABG (single graft). Primary end point was to compare the cardioprotective factors in DN and mST group. Result- In comparison to modified St Thomas group, del Nido group had lesser cardiopulmonary-bypass time(76.50 min vs 67.16 min), aortic cross clamp time( 60.60 min vs 53.52 min) and comparatively lesser rise in post-operative Troponin T level (1.027 ng/dl vs 0.719 ng/dl) and earlier appearance of first cardiac rhythm after removal of aortic cross clamp( 39.88 sec vs 29.52 sec) and lesser incidence( n=8) of re-dosing of cardioplegia administration, lower rate of post-operative defibrillation( six vs twenty) and lower post-operative complication rate ( three vs ten). Conclusion- Our study demonstrated that by using del Nido cardioplegia, there is in better myocardial protection and improved cardiac output in comparison to other standard cardioplegic solutions along with improved haemo-concentration. Hence, the del Nido cardioplegia can be a ‘magic bullet’ for cardiac surgeons

Description