Document Detail

del Nido versus Buckberg cardioplegia in adult isolated valve surgery.
MedLine Citation:
PMID:  25483897     Owner:  NLM     Status:  Publisher    
BACKGROUND: del Nido solution is a non-glucose-based, single-dose cardioplegic solution with few data supporting its safety in adults. We hypothesized that it and Buckberg solution offer myocardial protection of equivalent safety for isolated adult valve surgery.
METHODS: Adult patients undergoing primary isolated aortic or mitral valve surgery with del Nido or Buckberg solution from January 2010 to September 2013 were 1:1 propensity matched (85 aortic valve, 110 mitral valve), and outcomes were compared.
RESULTS: After aortic valve operations, no hospital deaths occurred, and troponin T levels (median 0.19 ng · mL(-1) for del Nido vs 0.21 ng · mL(-1) for Buckberg) were similar, with no statistically significant change in left ventricular ejection fraction (P = .4). Aortic clamp, bypass, and operating room times were shorter with del Nido solution (44 ± 14 vs 56 ± 19; 56 ± 18 vs 70 ± 24; and 285 ± 44 vs 308 ± 61 minutes, respectively; P < .0001). Peak intraoperative glucose levels (170 ± 31 vs 240 ± 41 mg · dL(-1); P < .0001) and postoperative insulin-drip requirements (46% vs 82%; P < .0001) were lower. After mitral operations, there were no hospital deaths and no statistically significant cardioplegia-specific changes in troponin T levels (median 0.37 ng · mL(-1) for del Nido vs 0.4 ng · mL(-1) for Buckberg) or postoperative left ventricular ejection fraction (P = .13). We found no clear time differences with del Nido solution in mitral cases, but intraoperative glucose levels and postoperative insulin-drip requirements (184 ± 37 vs 250 ± 60 mg · dL(-1) and 50% vs 67% mg · dL(-1), respectively; P = .009) were lower.
CONCLUSIONS: del Nido solution can be used safely and effectively as an alternative to Buckberg solution in adult isolated valve surgery and is associated with lower insulin requirements and potential time and cost savings.
Stephanie L Mick; Michael P Robich; Penny L Houghtaling; A Marc Gillinov; Edward G Soltesz; Douglas R Johnston; Eugene H Blackstone; Joseph F Sabik
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-22
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  -     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-12-8     Completed Date:  -     Revised Date:  2014-12-9    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.
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