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Research Article | Volume 13 Issue:3 (, 2023) | Pages 579 - 587
A Randomized control study to compare delNido and Saint Thomas cardioplegia solutions in isolated valvular heart surgery
Under a Creative Commons license
Open Access
DOI : 10.5083/ejcm
Published
July 24, 2023
Abstract

Background: The standard cardioplegia solution for adult cardiac surgery, Saint Thomas Hospital solution, has been used for a long time. However, the prolonged cardiac arrest period offered by delNido cardioplegia has generated significant interest. This study aims to compare outcomes and variables in isolated valvular heart surgery using delNido and Saint Thomas cardioplegia solutions. Methods: This randomized controlled study was conducted in the Department of Cardiothoracic and Vascular Surgery at IGMC&H, Shimla, Himachal Pradesh. Patients requiring heart valve surgery between November 2017 and December 2018 were included. Randomization was computer-generated, and allocation concealment was achieved using opaque sequentially numbered sealed envelopes. Appropriate statistical tests were used to assess associations between variables. Results: The study included 25 patients in each group. Group 1 (control) used Saint Thomas solution, while Group 2 (intervention) used delNido solution. Baseline parameters were similar between the groups. CPB and ACC times were slightly lower in the delNido group (114.48±37.73, 83.56±24.71) compared to the Saint Thomas group (132.64±37.73, 89.20±41.02), but the difference was not statistically significant. Cardioplegia volume was significantly lower in the delNido group. The delNido group required fewer inotropes, had a shorter ICU stay, fewer blood transfusions, and fewer defibrillations post aortic clamp removal, but these differences were not statistically significant. Mean duration of ventilation was higher in the delNido group, but not statistically significant. The delNido group had a significantly lower percentage of patients requiring defibrillation. Cardiac output values showed a significant difference at 72 hours post CPB, with a slight decrease in the delNido group. The interaction and main effect for CKMB levels were not statistically significant, but there was a significant main effect for CKMB values at 24 hours post CPB. Conclusion: Intraoperative and postoperative safety profiles of delNidocardioplegia were found to be similar to those of Saint Thomas cardioplegia in adult MVR/AVR± TV repair procedures.

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