Lee Heemoon, Kim Jihoon, Yoo Jae Suk
Department of Thoracic and Cardiovascular Surgery, Bucheon Sejong Hospital, Bucheon, Republic of Korea.
Department of Thoracic and Cardiovascular Surgery, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Republic of Korea.
Front Cardiovasc Med. 2025 Feb 25;12:1448310. doi: 10.3389/fcvm.2025.1448310. eCollection 2025.
Recent studies demonstrated satisfactory results of del Nido cardioplegia in minimally invasive cardiac surgery (MICS). We aimed to evaluate the efficacy of our modified "bloodless" del Nido cardioplegia in MICS compared to the histidine-tryptophan-ketoglutarate (HTK) solution.
We retrospectively reviewed 471 patients who underwent minimally invasive cardiac surgery (MICS) in our institution between January 2015 and September 2022. Patients were divided into HTK ( = 96) and bloodless del Nido ( = 375) groups. Using propensity score matching, we matched 72 patients with bloodless del Nido to 72 patients with HTK, based on demographic and operative information.
There were no significant differences in the baseline characteristics and operative data after matching. The early mortality and morbidities did not differ significantly between the two groups. Freedom from overall mortality did not differ significantly during the follow-up period (97.2% in HTK vs. 98.6 in bloodless del Nido at 2 years, = 0.56). The two groups had no difference in postoperative lactate levels at 6 and 24 h. Various statistical methods consistently indicated that bloodless del Nido cardioplegia did not increase risks for overall mortality.
The modified bloodless del Nido cardioplegia showed comparable postoperative outcomes in MICS compared with the HTK solution, suggesting its potential as an alternative option for MICS.
近期研究表明，德尔尼多停搏液在微创心脏手术（MICS）中取得了令人满意的效果。我们旨在评估改良的“无血”德尔尼多停搏液在MICS中与组氨酸-色氨酸-酮戊二酸（HTK）溶液相比的疗效。
我们回顾性分析了2015年1月至2022年9月在我院接受微创心脏手术（MICS）的471例患者。患者分为HTK组（n = 96）和无血德尔尼多组（n = 375）。利用倾向评分匹配法，根据人口统计学和手术信息，将72例使用无血德尔尼多停搏液的患者与72例使用HTK溶液的患者进行匹配。
匹配后两组患者的基线特征和手术数据无显著差异。两组患者的早期死亡率和发病率无显著差异。随访期间两组患者的总死亡率无显著差异（2年时HTK组为97.2%，无血德尔尼多组为98.6%，P = 0.56）。两组患者术后6小时和24小时的乳酸水平无差异。各种统计方法均一致表明，无血德尔尼多停搏液不会增加总死亡风险。
改良的无血德尔尼多停搏液在MICS中的术后效果与HTK溶液相当，表明其作为MICS替代方案的潜力。
