EVALUATION OF RIGHT VENTRICULAR SYSTOLIC FUNCTION AFTER CORONARY ARTERY BYPASS GRAFTING: THE IMPACT OF DEL NIDO CARDIOPLEGIA.

Background and Aim: We aimed to investigate the effects on postoperative right ventricular systolic function (RSVF) using different cardioplegic solutions and to evaluate the efficacy of Del Nido cardioplegia (DNC), compared with conventional crystalloid cardioplegia (CC), in adult patients undergoing coronary artery bypass grafting (CABG). TAPSE is a reliable, rapidly measurable, and easily replicable echocardiographic parameter for assessing longitudinal RVSF and, consequently, postoperative outcome in CABG surgery. RVSF is a major determinant of postoperative surgical outcome, so estimating the impact of cardioplegic solution on the reduction of ischemic damage is crucial. Methods: Our retrospective study included 118 patients treated with CABG. The population, homogeneous in terms of age, comorbidities, ejection fraction and operative timing, was divided into two groups according to the type of cardioplegia used during extracorporeal circulation (ECC): Group 1 consisting of 57 patients using CC, Group 2 consisting of 61 patients using DNC. RVSF was evaluated by echocardiography, assessing the tricuspid annular plane systolic excursion (TAPSE) pre and post-operatively. Results: Both groups showed a normal pre-operative TAPSE value (CC: 23 ± 2 mm vs DNC: 22.7 ± 2,4 mm; p=0.51). Postoperatively, in both groups the TAPSE was significantly reduced, as expected (CC: 13,3 ± 1,96 mm vs DNC: 14,7 ± 2,9 mm). Comparing the post-operative TAPSE value between groups, Group 2 showed a significantly higher value than Group 1 (p=0.003). Conclusions: The use of DNC in patients undergoing CABG improves short-term RVSF outcome, compared with the CC solution. In DNC-treated patients, the postoperative TAPSE showed a better RVSF.