Background

Myocardial protection is crucial for successful revascularization; multiple doses mixtures have been the cornerstone in adults. Del Nido cardioplegia (DLN CP) is used in pediatric population and in non-coronary adult surgery, limited data is still available on its application during CABG.

Methods

DLN CP was used in CABG procedures by the same team in a CV Center in the Dominican Republic. One-liter single dose ($10 each) was given anterogradely and repeated every 60 minutes if needed, systemic temperature was kept at 34 °C. Multivariate logistic regression was used to study CP variables related to LVEF conservation as primary outcome (figure). Clinical variables (IABP/inotrope use, extubation time, ICU/hospital length of stay) and costs were analyzed as secondary.

Results

Between January 2015 – October 2020, 290 consecutive CABG [age 63 (42-86) yrs, 80% male] were done. STS score median 0.78% (0.2-8.5%); 35% received transfusions; Cellsaver use 100%; inotropes 72%; no IABP used during/after surgery. Elective cases 54%, urgent 43%, emergency 3%. Overall mortality 2%; extubation time 5 hrs. (2-24); ICU stay: 4 (2-15) days; hospital stay: 8 (7-23) days. DLN CP related variables in figure. Average cost per patient $15.

Conclusion

In this series, use of DL CP in adults achieved optimal clinical parameters, recovery of spontaneous rhythm and shorter Xclamp times, favoring myocardial preservationpost CABG.