Department of Cardiovascular Surgery, Gaziantep University Medical Faculty, 27410 Gaziantep, Turkey.
Department of Operation Room Services, Gaziantep University Vocational School of Health Services, 27310 Gaziantep, Turkey.
Heart Surg Forum. 2023 Dec 27;26(6):E826-E831. doi: 10.59958/hsf.6381.
Cardioplegia solutions are used to protect the myocardium from ischemic injury caused by cardiopulmonary bypass and various types of cardioplegia solutions have been introduced for cardiac surgery. In this study, we aimed to compare the effects of del Nido cardioplegia and microplegia, which were mostly used in our clinic for intraoperative and postoperative processes among patients who underwent elective mitral valve replacement. As a result, the comparison could be performed in a specific patient group without additional valvular or coronary disease, and cardioplegia distribution could be achieved more efficiently.
Between 2018 and 2023, a total of 120 patients who underwent elective mitral valve replacement via sternotomy with del Nido cardioplegia or microplegia were included in the study. Patients were divided into two groups; group 1 (del Nido, n = 64) and group 2 (microplegia, n = 56). Preoperative characteristics, intraoperative and postoperative early clinical data as primary outcomes, and postoperative mortality rates and intensive care costs as secondary outcomes were compared statistically.
There were no statistically significant differences in terms of preoperative characteristics between the two groups. Duration of cross clamp differences between group 1 versus group 2 (45 ± 16 vs. 57 ± 19 min), cardiopulmonary bypass (56 ± 17 vs. 65 ± 21 min), intensive care length of stay (18.04 ± 7.41 vs. 22.37 ± 6.86 h), requirement of intraoperative defibrillation (n = 5 vs. n = 13), and intensive care costs were found to be statistically significantly lower in del Nido group.
Either del Nido or microplegia solutions can be used safely in mitral valve replacement operations, however, del Nido cardioplegia has some advantages over intraoperative processes, such as lowering the cross clamp and cardiopulmonary bypass time. Furthermore, patients who received del Nido cardioplegia had shorter intensive care stay and required less intraoperative defibrillation compared with the microplegia group. Therefore, less exposure to anesthesia, the prevention of infection due to shortened operation duration, and greater cost-effectiveness can be achieved by using del Nido cardioplegia instead of microplegia.
心脏停搏液用于保护心肌免受心肺转流和各种类型的心脏停搏液引起的缺血性损伤。在这项研究中，我们旨在比较心脏停搏液在我院用于心脏手术的术中及术后过程中最常使用的 del Nido 心脏停搏液和微心脏停搏液的效果。结果，可以在没有其他瓣膜或冠状动脉疾病的特定患者组中进行比较，并且可以更有效地实现心脏停搏液的分布。
2018 年至 2023 年，共有 120 例经胸骨切开术行选择性二尖瓣置换术的患者纳入研究。患者分为两组；第 1 组（del Nido，n = 64）和第 2 组（microplegia，n = 56）。比较了主要结局的术前特征、术中及术后早期临床数据，以及次要结局的术后死亡率和重症监护费用。
两组患者的术前特征无统计学差异。第 1 组与第 2 组之间的体外循环时间差异（45 ± 16 对 57 ± 19 分钟）、体外循环时间（56 ± 17 对 65 ± 21 分钟）、重症监护停留时间（18.04 ± 7.41 对 22.37 ± 6.86 小时）、术中除颤需求（n = 5 对 n = 13）和重症监护费用在 del Nido 组中均有统计学意义。
在二尖瓣置换术中可以安全使用 del Nido 或微心脏停搏液，但 del Nido 心脏停搏液在术中过程中具有一些优势，例如降低体外循环时间和体外循环时间。此外，与 microplegia 组相比，接受 del Nido 心脏停搏液的患者重症监护停留时间更短，术中需要除颤的次数更少。因此，使用 del Nido 心脏停搏液替代 microplegia 可以减少麻醉暴露、缩短手术时间以预防感染以及提高成本效益。
