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2 . 2021

Del Nido and Buckberg cardioplegia in coronary artery bypass patients: single-center prospective study

Abstract

Aim of the study - compare the effectiveness of myocardial protection when using del Nido and Buckberg cardioplegia in patients with ischemic heart disease.

Material and methods. Prospective, single-center non-randomized study. The study included 150 patients (del Nido - 75 patients, Buckberg - 75 patients). In each group, 57 patients underwent isolated coronary bypass surgery, and 18 patients underwent combined coronary bypass surgery with prosthetics/plastic surgery of one of the heart valves.

Results. Average total number of grafts (2.7±0.09 in the del Nido group and 2.7±0.09 in the Buckberg group, p=0.95) and the average number of arterial grafts (1.05±0.06 in the del Nido group and 1.12±0.08 in the Buckberg group, p=0.59) did not differ significantly. In the del Nido group, the aortic cross-clamping time (63.8±26 vs to 74.6±37 minutes in the group of Buckberg, p=0.02), the total time of extracorporeal circulation (98.7±33 vs 115.3±46 minutes, p=0.008), time of extracorporeal circulation after aortic cross-clamping (30.4±11 vs 34.4±10 min, p=0.007) and total time of operation (of 221.8±45 vs 251.7±65 min, p=0.008) were significantly lower than in the Buckberg group. The frequency of spontaneous recovery of normal rhythm after removal of aortic transverse clamp (90.7 vs 84%), development of ventricular fibrillation (12 vs 14.7%) and intraoperative defibrillation (9.3 vs 14.7%) did not differ statistically significantly (p>0.05). In the postoperative period, the duration of inotropic/vasopressor support, stay in the ICU and the total period of hospitalization did not differ statistically (p>0.05). Dependence on an artificial pacemaker in the postoperative period (2.7 vs 13.5%, p=0.01) and paroxysms of atrial fibrillation were more frequently observed in the Buckberg group (14.7 vs 26.7%, p=0.07). The level of CK-MB in 12-16 hours after surgery was lower in the del Nido group (26.3±17 vs 45.1+60 U/l, p=0.0002).

Conclusion. del Nido cardioplegia is safe and effective in patients with coronary artery disease. In comparison with Buckberg cardioplegia, the use of del Nido cardioplegia might reduce extracorporeal circulation, cross-clamping and the total operation time. We determined that in the del Nido group, CK-MB values were significantly lower in the early postoperative period, which positively characterizes the protective properties of this method. In addition, the del Nido group showed a lower rate of dependence on a temporary artificial pacemaker in the early postoperative period.

Keywords:cardiac surgery, coronary bypass surgery, myocardial protection, cardioplegia, del Nido, Buckberg

Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Klyshko N.K., Furgal A.A., Shchava S.P., Silaev A.A., Zenina A.A., Savushkina N.V., Kondrashova N.M., Stepanov E.V., Goncharuk R.A., Sorokin V.A. Del Nido and Buckberg cardioplegia in coronary artery bypass patients: singlecenter prospective study. Clinical and Experimental Surgery. Petrovsky Journal. 2021; 9 (2): 76-83. DOI: https://doi.org/10.33029/2308-1198-2021-9-2-76-83  (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

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