Turkyilmaz Gulsum, Kavala Ali Aycan
Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Derg. 2024 Dec 31;32(4 Suppl 2):066-66. doi: 10.5606/tgkdc.dergisi.2024.msb-41. eCollection 2024 Nov.
The study aimed to compare del Nido cardioplegia (DNC) with blood cardioplegia (BC) in coronary artery bypass grafting (CABG) combined with mitral valve replacement.
This single-center retrospective cohort study was conducted. Sixty patients who underwent CABG (up to triple bypass) combined with mitral valve replacement were divided into DNC and BC groups, with thirty patients in each group.
Both groups demonstrated similar baseline characteristics, including age, sex, cardiac/noncardiac comorbidity, and preoperative echocardiographic parameters. Compared to the BC group, the DNC group demonstrated significantly lower cardioplegia volume (1130.00±194.1 mL 884.33±156.8 mL, p=0.001), cardiopulmonary bypass time (121.70±13.57 min 110.90±12.52 min, p=0.002), aortic clamp time (101.37±13.87 min 91.37±11.58 min, p=0.004), and need for intraoperative defibrillation (21 events 6 events, p=0.001). Postoperative creatine kinase-MB levels and troponin levels were significantly lower in the DNC group than in the BC group. Postoperative hemoglobin and hematocrit levels were significantly higher in the DNC group than in the BC group. The intubation period in intensive care unit was significantly shorter in the BC group (6.82±1.57 h 8.13±12.21 h, p=0.037); however, intensive care unit stay, total hospital stay, and postoperative complication rates were not significantly different between the groups. At predischarge echocardiography, the DNC group demonstrated significantly higher ejection fraction rates than the BC group (47.79±5.50 and 45.72±5.86, respectively; p=0.005).
Del Nido cardioplegia presented better intraoperative and postoperative results. Therefore, it can be concluded that DNC is an effective and safe alternative to BC for CABG combined with mitral valve replacement.
本研究旨在比较在冠状动脉旁路移植术（CABG）联合二尖瓣置换术中，德尔尼多停搏液（DNC）与血液停搏液（BC）的效果。
进行了这项单中心回顾性队列研究。60例行CABG（最多三支血管搭桥）联合二尖瓣置换术的患者被分为DNC组和BC组，每组30例。
两组患者的基线特征相似，包括年龄、性别、心脏/非心脏合并症以及术前超声心动图参数。与BC组相比，DNC组的停搏液用量显著更低（1130.00±194.1 mL对884.33±156.8 mL，p = 0.001）、体外循环时间显著更短（121.70±13.57分钟对110.90±12.52分钟，p = 0.002）、主动脉阻断时间显著更短（101.37±13.87分钟对91.37±11.58分钟，p = 0.004），且术中除颤需求显著更少（21次对6次，p = 0.001）。DNC组术后肌酸激酶-MB水平和肌钙蛋白水平显著低于BC组。DNC组术后血红蛋白和血细胞比容水平显著高于BC组。BC组在重症监护病房的插管时间显著更短（6.82±1.57小时对8.13±12.21小时，p = 0.037）；然而，两组在重症监护病房停留时间、总住院时间和术后并发症发生率方面无显著差异。出院前超声心动图检查时，DNC组的射血分数率显著高于BC组（分别为47.79±5.50和45.72±5.86；p = 0.005）。
德尔尼多停搏液在术中和术后表现出更好的效果。因此，可以得出结论，对于CABG联合二尖瓣置换术，DNC是BC的一种有效且安全的替代方法。
