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Is del Nido cardioplegia safe in isolated coronary bypass surgery? It may be possible with this method

Ferhat Borulu¹, Yasin Kılıç², Bilgehan Erkut², Melih Ürkmez¹, Kaptanıderya Tayfur<sup>1

1</sup>Department of Cardiovascular Surgery, Ordu University Faculty of Medicine, Ordu, Türkiye
²Department of Cardiovascular Surgery, Atatürk University Faculty of Medicine, Erzurum, Türkiye

Keywords: Cardioplegia, coronary artery bypass surgery, del Nido

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Objectives: This study aimed to share the early results of the del Nido (DN) solution used with a different method in patients who underwent isolated coronary bypass.

Patients and methods: The retrospective study included 150 patients (123 males, 27 females; mean age: 59.8±9.7 years; range, 38 to 84 years) who underwent isolated coronary bypass operation between January 2020 and May 2022. The DN solution was applied differently from the practice in the literature. Seventy-five percent of the dose calculated according to the body weight of the patients was administered at the first moment. The remaining amount was continued to be given through the saphenous veins as distal anastomoses were made. When the cross-clamp was lifted, all grafts were tied to the aorta cannula, and the coronary vascular bed was cleared. Follow-up of patients was done routinely.

Results: The mean preoperative ejection fraction was 49.9±5.6, and the mean postoperative ejection fraction value was 50.3±5.0 (p=0.079). A statistically significant difference was found between the preoperative troponin level and the postoperative troponin level at 6 h (p<0.001). However, there was no significant difference between the postoperative 6 h and the postoperative 24 h. Spontaneous rhythm occurred at the termination of cardiopulmonary bypass in most of the patients (97%). No permanent pacing was required in any patient. An intra-aortic balloon pump was used in nine patients, and extracorporeal membrane oxygenation was used in two patients. Two patients died in the early period.

Conclusion: The use of DN with this method seems to be a reliable alternative to eliminate hesitations in isolated coronary bypass surgery.

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