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Abstract
Background: Cardiovascular diseases remain the leading cause of morbidity and mortality worldwide, resulting in an increasing demand for effective myocardial protection strategies during cardiac surgery. Cardioplegia plays a crucial role in minimizing ischemia-reperfusion injury during cardiopulmonary bypass. Del Nido cardioplegia, originally developed for pediatric cardiac surgery, has gained increasing acceptance in adult cardiac procedures because of its prolonged myocardial protective effects. This study aimed to compare the effectiveness of Del Nido cardioplegia with conventional cardioplegia in adult patients undergoing coronary artery bypass grafting and valvular heart surgery.
Methodology: A retrospective comparative study was conducted at a tertiary cardiac care hospital. A total of 136 adult patients were included, comprising 68 patients who received Del Nido cardioplegia and 68 patients who received conventional cardioplegia. Demographic characteristics, intraoperative variables, postoperative biochemical markers, intensive care unit stay, inotropic support requirements, postoperative blood loss, major complications, and renal and hepatic biochemical parameters were obtained from hospital medical records. Statistical analysis was performed using SPSS version 26.0, with a p-value of <0.05 considered statistically significant.
Results: Patients receiving Del Nido cardioplegia demonstrated significantly shorter aortic cross-clamp time (69 vs. 74 minutes; p = 0.041) and cardiopulmonary bypass duration (121 vs. 129 minutes; p = 0.032) compared with the conventional cardioplegia group. Del Nido cardioplegia was associated with a significantly shorter ICU stay (5 vs. 6 days; p = 0.002), lower postoperative Troponin-T (228 vs. 392 ng/L; p < 0.001) and CK-MB (15 vs. 24 U/L; p < 0.001) levels, reduced inotropic support, decreased postoperative blood loss, fewer major postoperative complications, and improved postoperative renal and hepatic biochemical profiles.
Conclusion: Del Nido cardioplegia demonstrated superior myocardial protection and improved early postoperative outcomes compared with conventional cardioplegia in adult patients undergoing CABG and valvular heart surgery. Its use was associated with improved operative efficiency, reduced myocardial injury, enhanced postoperative recovery, and lower complication rates. These findings support Del Nido cardioplegia as a safe and effective myocardial protection strategy in adult cardiac surgery. Further large-scale prospective multicenter studies are recommended to validate these findings and evaluate long-term clinical outcomes.