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Purpose <p>Research on the safety and efficacy of del Nido cardioplegia in complex adult cardiac surgeries with prolonged aortic cross-clamp times remains limited. This study aimed to compare early clinical outcomes between the use of del Nido and blood cardioplegia in this patient cohort.</p> Methods <p>A comprehensive database search was conducted using PubMed, Scopus, and the Cochrane Central Register of Controlled Trials through August 2024 to perform a meta-analysis comparing del Nido versus blood cardioplegia in adult cardiac surgery with prolonged aortic cross-clamp time (≥ 90&#xa0;min). The primary endpoint was early mortality, and secondary endpoints included postoperative morbidity, left ventricular ejection fraction (LVEF), and cardiac enzymes. A random effects model was used to estimate the pooled effect size.</p> Results <p>Six studies met our eligibility criteria, including three propensity score–matched studies, with a total of 1916 patients. The incidence of early mortality was comparable between the del Nido and control groups, with a pooled odds ratio of 1.25 (95% confidence interval: 0.90, 1.25; <i>p</i> = 0.147). The incidence of postoperative stroke (<i>p</i> = 0.137), renal failure (<i>p</i> = 0.796), and atrial fibrillation (<i>p</i> = 0.449); postoperative LVEF (<i>p</i> = 0.379), and highest creatine kinase-myocardial band level (<i>p</i> = 0.151) were also similar. Highest troponin T level was significantly lower in the del Nido group with a standardized mean difference of − 0.22 (− 0.44, − 0.00; <i>p</i> = 0.049).</p> Conclusions <p>In adult cardiac surgery with prolonged aortic cross-clamp, del Nido cardioplegia provides comparable myocardial protection and early mortality and morbidity rates compared to conventional blood cardioplegic solutions.</p>

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Del Nido versus blood cardioplegia in cardiac surgery with prolonged aortic cross-clamp time: a meta-analysis

  • 期刊论文

  • 发表日期：

    2025年9月22日

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  • Yoshiyuki Yamashita,
  • Massimo Baudo,
  • Dimitrios Magouliotis,
  • Francesco Cabrucci,
  • Serge Sicouri,
  • Basel Ramlawi

摘要

Purpose

Research on the safety and efficacy of del Nido cardioplegia in complex adult cardiac surgeries with prolonged aortic cross-clamp times remains limited. This study aimed to compare early clinical outcomes between the use of del Nido and blood cardioplegia in this patient cohort.

Methods

A comprehensive database search was conducted using PubMed, Scopus, and the Cochrane Central Register of Controlled Trials through August 2024 to perform a meta-analysis comparing del Nido versus blood cardioplegia in adult cardiac surgery with prolonged aortic cross-clamp time (≥ 90 min). The primary endpoint was early mortality, and secondary endpoints included postoperative morbidity, left ventricular ejection fraction (LVEF), and cardiac enzymes. A random effects model was used to estimate the pooled effect size.

Results

Six studies met our eligibility criteria, including three propensity score–matched studies, with a total of 1916 patients. The incidence of early mortality was comparable between the del Nido and control groups, with a pooled odds ratio of 1.25 (95% confidence interval: 0.90, 1.25; p = 0.147). The incidence of postoperative stroke (p = 0.137), renal failure (p = 0.796), and atrial fibrillation (p = 0.449); postoperative LVEF (p = 0.379), and highest creatine kinase-myocardial band level (p = 0.151) were also similar. Highest troponin T level was significantly lower in the del Nido group with a standardized mean difference of − 0.22 (− 0.44, − 0.00; p = 0.049).

Conclusions

In adult cardiac surgery with prolonged aortic cross-clamp, del Nido cardioplegia provides comparable myocardial protection and early mortality and morbidity rates compared to conventional blood cardioplegic solutions.