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Del Nido Cardioplegia for Myocardial Protection in Adult Cardiac Surgery: A Systematic Review and Meta-Analysis

Li, Yongnan; Lin, Hao; Zhao, Yinglu; Li, Zhenzhen; Liu, Debin; Wu, Xiangyang; Ji, Bingyang; Gao, Bingren
doi: 10.1097/MAT.0000000000000652
Clinical Cardiovascular: PDF Only

Cardioplegia is an important strategy for myocardial protection during cardiac surgery. This meta-analysis was to compare the effects of del Nido and conventional cardioplegia in adult patients. Systematic searches were performed to identify studies using PubMed, Embase, the Cochrane Library, and the International Clinical Trials Registry Platform. A total of nine studies were included. Cardiopulmonary bypass and cross-clamp time were significantly shorter in the del Nido than conventional cardioplegia (mean difference [MD]: −7.52, 95% confidence interval [95% CI]: −14.76 to −0.29, p = 0.04; MD: −5.74, 95% CI: −10.14 to −1.34, p = 0.01). During the operation, cardioplegia volume and blood glucose level were lower in the del Nido group (MD: −522.53, 95% CI: −926.68 to −118.37, p = 0.01; standardized mean difference [SMD]: −1.11, 95% CI: −1.74 to −0.48, p = 0.0006). Ventilation time and length of intensive care unit were decreased significantly with del Nido cardioplegia (MD: −1.05, 95% CI: −1.79 to −0.31, p = 0.006; MD: −0.65, 95% CI: −0.92 to −0.38, p < 0.00001). There were no differences in myocardial enzyme, postoperative inotropic support, atrial fibrillation, hospital, and mortality between the two groups. In adult cardiac surgery, myocardial protection used with the del Nido or conventional cardioplegia solution yield similar short-term clinical outcomes.

Submitted for consideration November 2016; accepted for publication in revised form August 2017.

Bingyang Ji and Bingren Gao contributed equally to this work.

This study was supported by the Fundamental Research Funds for the Central Universities (lzujbky-2016-sp05).

Disclosure: The authors have no conflicts of interest to report.

Correspondence: Bingyang Ji, Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Medicine, Fuwai Hospital, National Center for Cardiovascular disease, Chinese Academy of Medical Science and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing 10010, China. Email: jibingyang@fuwai.com; and Bingren Gao, Department of Cardiac Surgery, Lanzhou University Second Hospital, No. 80, Cuiyingmen, Chengguan District, Lanzhou 730030, China. Email: bingrengao@foxmail.com.

Copyright © 2017 by the American Society for Artificial Internal Organs