THE NOT-WEIGHT-BASED DOSING STRATEGY OF DELNIDO CARDIOPLEGIA IS SAFE AND EFFECTIVE IN ACHIEVING MYOCARDIAL PROTECTION IN CARDIAC SURGERIES WITH STANDARD AND PROLONGED CROSS-CLAMP: PRELIMINARY RESULTS FROM I.R.DE.N. REGISTRY

Background: The use of delNido cardioplegia in adult cardiac surgery is increasing, with studies evaluating its safety yielding mixed results. Despite good perioperative outcomes, some suggest higher long-term postoperative mortality. Key debates include dosing strategies, with some centers using weight-based dosing and others following delNido’s protocol of a single 1000 ml dose for patients over 70 kg. This study reports on the outcomes of a standard dosing and redosing protocol in patients undergoing isolated or combined coronary artery bypass grafting (CABG) with normal and prolonged cross-clamp times. Methods: A retrospective single-center analysis was carried out on 207 patients who underwent isolated or combined CABG. The patients were divided into groups according to the type of cardioplegia (delNido vs. cold blood), and perioperative outcomes were compared. This analysis included patients with cross-clamp times longer than 80 minutes. Results: There were no baseline or preoperative risk profile differences between the groups. Although delNido patients had a slightly higher median cross-clamp time, both groups were similar in terms of postoperative troponin release, ICU and hospital stays, and 12-month survival. The delNido group required less inotropic support, both in terms of duration (p<0.001) and total dose (p=0.015). However, among patients with prolonged cross-clamp times, there were no differences in survival or postoperative outcomes. Conclusions: The delNido cardioplegia, using a non-weight-based protocol, appears to be safe and effective for myocardial protection in cardiac surgeries, including those with standard and prolonged cross-clamp times.