Comparison of del Nido cardioplegia and blood cardioplegia in adults undergoing minimally invasive cardiac surgery: A retrospective cohort study

The purpose of this study was to compare the safety and myocardial protective effects of del Nido cardioplegia (DC) and blood cardioplegia (BC) in adults undergoing minimally invasive cardiac surgery. A retrospective analysis was conducted on data from 116 patients who underwent minimally invasive cardiac surgery between January 2019 and December 2023. Patients were divided into two groups (DC [n = 63] and BC [n = 53]) based on the type of cardioplegia used to achieve cardiac arrest. Surgical and postoperative outcomes of the two groups were compared. The demographic characteristics of the two groups were similar. The cardiopulmonary bypass (CPB) time (DC: 128 [122,163] minutes vs. BC: 142 [128,188] minutes; P = 0.017) and aortic cross-clamp (ACC) time (DC: 76 [68,94] minutes vs. BC: 89 [76,127] minutes; P = 0.005) were significantly shorter in the DC group. Moreover, the peak glucose level in the DC group was lower (DC: 166 ± 37 vs. BC: 218 ± 61 mg/dL, P < 0.001), as were the number of patients requiring defibrillation (DC: 6.3 % vs. BC: 22.6 %, P = 0.011) and the postoperative peak troponin levels (DC: 13.4 ± 6.0 vs. BC: 17.1 ± 9.9 ng/ml, P = 0.016). Likewise, the ventilation time (DC: 20 [18,25] hours vs. BC: 24 [22,27.5] hours; P = 0.005) and intensive care unit (ICU) stay (DC: 21 [19,26] hours vs. BC: 26 [24,30] hours; P < 0.001) were shorter in the DC group. This study confirms the safety and myocardial protective effects of DC in adult minimally invasive cardiac surgery, with potential benefits including a reduction in the incidence of ventricular fibrillation, shorter ventilation times, and decreased ICU stays.