Cardioplejía Del Nido: una estrategia de protección miocárdica segura, eficaz y económica

Introduction: The choice of the optimal cardioplegic solution is still under debate. Del Nido cardioplegia (originally designed for the paediatric population) is gaining popularity in the field of adult cardiac surgery.Methods: A study was conducted on a consecutive series of 30 patients who received Del Nido cardioplegia as myocardial protection strategy. Demographic and risk profile parameters, procedure performed, and surgical survival were registered, as well as main the perfusion variables, intraoperative haematocrit variation, and myocardial injury enzymatic release during the postoperative period. Formulation costs compared with conventional commercial solutions were determined.Results: Survival of the series was 100%. Electromechanical arrest of the heart was achieved in all cases. The group of procedures performed were combined valvular/coronary surgery (43.34%), isolated valve surgery (30.00%), coronary artery bypass graft surgery (13.34%), and interventions with more than 2 procedures (13.34%). After myocardial reperfusion, spontaneous defibrillation of the heart occurred in 83.34%. Weaning from cardiopulmonary bypass was successful in 100% with no mechanical circulatory support, and low-dose inotropic support with dobutamine. The estimated preparation costs were set at 7.39 euros per unit.Conclusions: Del Nido cardioplegia is routinely used in clinical practice both in paediatric and adult population in high volume centres. It could be a safe, effective and cheap myocardial protection strategy of universal implementation in cardiac surgery. Additional prospective studies are needed to confirm these data. (C) 2014 Sociedad Espanola de Cirugia Torkica-Cardiovascular. Published by Elsever Espana, S.L.U. All rights reserved.