Outcomes of del Nido cardioplegia after surgical aortic valve replacement and coronary artery bypass grafting.

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Citation: General Thoracic & Cardiovascular Surgery. 71(9):491-497, 2023 Sep.PMID: 36843184Institution: MedStar Heart & Vascular Institute | MedStar Heart & Vascular Institute | MedStar Heart & Vascular Institute | MedStar Heart & Vascular Institute | MedStar Heart & Vascular Institute | MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2023ISSN:
  • 1863-6705
Name of journal: General thoracic and cardiovascular surgeryAbstract: CONCLUSIONS: The use of DNC cardioplegia in our cohort of adult patients who underwent SAVR +/- CABG was safe and associated with improved postoperative outcomes. However, the use of DNC may be associated with higher degrees of myocardial injury. Copyright © 2023. The Author(s), under exclusive licence to The Japanese Association for Thoracic Surgery.METHODS: All SAVR +/- CABG procedures were switched from BC to DNC at our institute in 2012. We compared outcomes of BC (November 2007-October 2012; n = 1037) with DNC (November 2012-December 2017; n = 1067). Significant baseline differences were observed between the two groups and such differences were adjusted via inverse propensity treatment weighting.OBJECTIVE: The use of del Nido cardioplegia (DNC) was initially adopted in the field of pediatric cardiac surgery. Several studies in adult patients suggested there were no differences in early postoperative outcomes as compared to blood-based cardioplegia. We sought to evaluate the impact of DNC as compared to modified Buckberg cardioplegia (BC) on early postoperative outcomes in patients undergoing surgical aortic valve replacement with and without coronary artery bypass grafting (SAVR +/- CABG).RESULTS: After adjustment, SAVR +/- CABG patients who received DNC required longer aortic cross-clamp times, while postoperative peak troponin I and creatinine kinase-MB isotype were significantly lower in the BC group. Length of hospital and intensive care unit stay were significantly shorter in the DNC group. The incidence of postoperative complications was lower in the DNC cohort. Thirty-day mortality rate was significantly lower in the DNC group (3.0% vs 4.9%, p = 0.002).All authors: Kitahara H, Molina EJ, Nakai C, Shults C, Waksman R, Zhang CFiscal year: FY2024Digital Object Identifier: Date added to catalog: 2023-10-04
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Journal Article MedStar Authors Catalog Article 36843184 Available 36843184

CONCLUSIONS: The use of DNC cardioplegia in our cohort of adult patients who underwent SAVR +/- CABG was safe and associated with improved postoperative outcomes. However, the use of DNC may be associated with higher degrees of myocardial injury. Copyright © 2023. The Author(s), under exclusive licence to The Japanese Association for Thoracic Surgery.

METHODS: All SAVR +/- CABG procedures were switched from BC to DNC at our institute in 2012. We compared outcomes of BC (November 2007-October 2012; n = 1037) with DNC (November 2012-December 2017; n = 1067). Significant baseline differences were observed between the two groups and such differences were adjusted via inverse propensity treatment weighting.

OBJECTIVE: The use of del Nido cardioplegia (DNC) was initially adopted in the field of pediatric cardiac surgery. Several studies in adult patients suggested there were no differences in early postoperative outcomes as compared to blood-based cardioplegia. We sought to evaluate the impact of DNC as compared to modified Buckberg cardioplegia (BC) on early postoperative outcomes in patients undergoing surgical aortic valve replacement with and without coronary artery bypass grafting (SAVR +/- CABG).

RESULTS: After adjustment, SAVR +/- CABG patients who received DNC required longer aortic cross-clamp times, while postoperative peak troponin I and creatinine kinase-MB isotype were significantly lower in the BC group. Length of hospital and intensive care unit stay were significantly shorter in the DNC group. The incidence of postoperative complications was lower in the DNC cohort. Thirty-day mortality rate was significantly lower in the DNC group (3.0% vs 4.9%, p = 0.002).

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