Comparison of the clinical effects of del Nido cardioplegia and HTK cardioplegia in cardiac valve replacement

Huang Honghao; Yang Ke; Wei Xiaohong; He Siyi; Zhou Yi; Gao Feng; Zhang Jinbao; Li Xia; Xin Mei

doi:10.13498/j.cnki.chin.j.ecc.2024.02.05

Abstract：Objective To retrospectively evaluate the clinical effects of del Nido and histidine-tryptophane-ketoglutarate(HTK)cardioplegia during cardiac valve replacement,with the aim of providing reference for their clinical application.Methods Data from 496 patients who underwent treatment at Department of Cardiovascular Surgery,General Hospital of Western Theater Command between January 1st,2018 and September 10th,2023 were retrospectively analysed.Exclusion criteria eliminated certain data,and bias score matching was done on some attributes of both groups with the SPSS22.0 statistical software.A total of 102 patients were enrolled,with 51 in the DN group and 51 in the HTK group.The intraoperative characteristics of both groups were documented,and the myocardial injury markers CK-MB and cTnI,along with the results of blood gas analysis and complications,were compared between them at various time intervals following surgery.The study examined the correlation between myocardial injury markers and the duration of aortic occlusion time in the ICU.Lastly,the aortic occlusion time was classified into two subgroups:less than 90 minutes and 90-120 minutes,for further analysis.Results The fundamental characteristics of patients in both groups showed no statistical significance before and after propensity matching.However,there were statistically significant differences in the total amount of cardioplegia,K+,CPB time,and aortic clamping time observed among the DN and HTK groups before and after propensity matching(P<0.05).Notably,the aortic clamping time in the DN and HTK groups exhibited a positive correlation with CK-MB and cTnI.There were statistically significant variations in CK-MB and cTnI levels between the DN and HTK groups during 90-120 minutes,as indicated by subgroup analysis(P<0.05).Conclusion Both types of cardiac arrest fluids are highly safe.Moreover,no significant difference was found in the myocardial protection effect between the two groups while using the two cardioplegia solutions for surgeries lasting less than 90 minutes.However,surgeries lasting between 90-120 minutes may benefit from del Nido cardioplegia solution due to its superior myocardial protection and price advantage.