Evaluation of Myocardial Protection Efficacy of del Nido Cardioplegia: A Comparative Study with Intermittent Cold Blood Cardioplegia

Aim: Effective myocardial protection is crucial for successful outcomes in open-heart surgery. Hyperkalemic solutions have traditionally been used, with improvements leading to various cardioplegia types. Del Nido cardioplegia , initially designed for pediatric use, is increasingly adopted in adult cardiac surgery. This study aims to evaluate the efficacy of del Nido cardioplegia in myocardial protection based on clinical, biochemical, and hemodynamic parameters.Materials and Methods: Thirty patients who underwent coronary artery bypass grafting between July and September 2018 at our clinic were included. Patients had similar demographics. Del Nido Cardioplegia was used in 15 patients, and intermittent cold blood cardioplegia after crystalloid induction was used in the remaining 15 patients. Preoperative, intraoperative, and postoperative data were analyzed.Results: No significant differences were observed between groups regarding demographic characteristics, comorbidities, or surgical technique (p>0.05). Pre- and postoperative values for ejection fraction, cardiac output, and cardiac index showed no statistical differences (p>0.05). Troponin I patterns were also similar (p>0.05). Cross-clamp and cardiopulmonary bypass times were significantly shorter in the del Nido Cardioplegia group (48.9±2.8 min and 70.2±2.2 min) compared to the blood cardioplegia group (55.5±2.9 min and 78±2.7 min) (p<0.001). The del Nido cardioplegia group also had a lower requirement for defibrillation post-clamp removal (p<0.001). No differences were found regarding postoperative complications or intensive care unit stay duration (p>0.05).Conclusion: Del Nido cardioplegia provides effective myocardial protection comparable to blood cardioplegia and may offer advantages in surgical flow due to reduced perfusion times, supporting its safe use in adult coronary artery bypass graft procedures.