Int J Angiol
DOI: 10.1055/s-0039-3400747
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Whole Blood del Nido versus Cold Blood Microplegia in Adult Cardiac Surgery: A Propensity-Matched Analysis

Taylor M. James
1  Graduate Medical Education MD/MPH Program, University of Miami Miller School of Medicine, Miami, Florida
,
2  Department of Cardiothoracic Surgery, JFK Medical Center, Atlantis, Florida
,
Cristiano Faber
2  Department of Cardiothoracic Surgery, JFK Medical Center, Atlantis, Florida
,
Marcos A. Nores
2  Department of Cardiothoracic Surgery, JFK Medical Center, Atlantis, Florida
› Author Affiliations
Funding No funding was obtained for the study.
Further Information

Publication History

Publication Date:
31 December 2019 (online)

Abstract

Objectives Few studies have evaluated the outcomes of whole blood microplegia in adult cardiac surgery. Our novel protocol includes removing the crystalloid portion and using the Quest Myocardial Protection System (MPS) for the delivery of del Nido additives in whole blood. This study sought to compare early and late clinical outcomes of whole blood del Nido microplegia (BDN) versus cold blood cardioplegia (CBC) following adult cardiac surgery.

Methods A total of 361 patients who underwent cardiac surgery using BDN were compared with a contemporaneous control group of 934 patients receiving CBC. Propensity matching yielded 289 BDN and 289 CBC patients. Chi-square analysis and Fisher's exact test were performed to compare preoperative, operative, and postoperative characteristics on the matched data. Primary outcome was operative mortality, and secondary outcomes included clinical outcomes such as stroke, cardiac arrest, and intra-aortic balloon pump use. The Kaplan–Meier method was used to compare actuarial survival between the two groups using a log-rank test.

Results After matching, preoperative characteristics and surgery type were similar between groups. Cardioplegia type did not affect the primary end point of operative mortality. The rate of postoperative intra-aortic balloon pump was lower in BDN patients compared with CBC patients (0 vs. 2%; p = 0.01). There was no difference in late survival.

Conclusions Our novel protocol BDN was comparable with CBC, with similar clinical outcomes and no difference in operative mortality or actuarial survival. Further studies should evaluate the long-term outcomes of this technique.