Lin Sun, Xiaoyu Zhou, Lingfeng Xu, Xin Chang, Zhen Guo
School of Medicine, Tongji University, Shanghai, China; Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Cardiothorac Vasc Anesth. 2025 Mar;39(3):635-643. doi: 10.1053/j.jvca.2024.12.006. Epub 2024 Dec 7.
The myocardial-protective effect of del Nido cardioplegia solution was evaluated in adult patients undergoing prolonged aortic cross-clamping during cardiac surgery.
Prospective cohort.
Single-center tertiary academic medical center.
A total of 462 patients scheduled for cardiac surgery under cardiopulmonary bypass with an expected aortic cross-clamp time >120 minutes between January 2020 and January 2024 were enrolled.
Patients with an expected aortic cross-clamp time >120 minutes were randomly assigned to low- and high-risk del Nido and Buckberg groups, with 112 patients in each group. Serum levels of cardiac troponin T and creatine kinase-MB were measured at 1, 24, and 48 hours after operation. The occurrence of atrial fibrillation within 48 hours postoperatively and other intraoperative and postoperative parameters were recorded.
No significant differences were observed in preoperative parameters between the groups. The level of cardiac troponin T was significantly higher in the low-risk del Nido group than in the Buckberg group at 24 hours postoperatively (p < 0.05). However, no significant differences were observed in cardiac troponin T or creatine kinase-MB levels at the other time points. The incidence of postoperative atrial fibrillation in the Buckberg group at 48 hours was significantly higher than the del Nido group in both the low- and high-risk groups (p < 0.05).
The incidence of postoperative atrial fibrillation at 48 hours was significantly lower in the del Nido group than in the Buckberg group. del Nido cardioplegia solution can be safely used for high-risk patients undergoing prolonged aortic cross-clamping.
在心脏手术中接受长时间主动脉阻断的成年患者中评估德尔尼多心脏停搏液的心肌保护作用。
前瞻性队列研究。
单中心三级学术医疗中心。
纳入2020年1月至2024年1月期间计划在体外循环下进行心脏手术且预期主动脉阻断时间>120分钟的462例患者。
预期主动脉阻断时间>120分钟的患者被随机分配至低风险和高风险的德尔尼多组与巴克伯格组，每组112例。术后1、24和48小时测量血清心肌肌钙蛋白T和肌酸激酶同工酶MB水平。记录术后48小时内房颤的发生情况以及其他术中及术后参数。
各组术前参数无显著差异。术后24小时，低风险德尔尼多组的心肌肌钙蛋白T水平显著高于巴克伯格组（p<0.05）。然而，在其他时间点，心肌肌钙蛋白T或肌酸激酶同工酶MB水平无显著差异。在低风险和高风险组中，巴克伯格组术后48小时房颤发生率均显著高于德尔尼多组（p<0.05）。
德尔尼多组术后48小时房颤发生率显著低于巴克伯格组。德尔尼多心脏停搏液可安全用于接受长时间主动脉阻断的高危患者。
