title: Del Nido Cardioplegia can be safely administered in high-risk coronary artery bypass grafting surgery after acute myocardial infarction: a propensity matched comparison.
abstract: OBJECTIVE
  Del Nido (DN) cardioplegia solution provides a depolarized hyperkalemic arrest lasting up to 60 minutes, and the addition of lidocaine may limit intracellular calcium influx. Single-dose DN cardioplegia solution may offer an alternative myocardial protection strategy to multi-dose cold whole blood (WB) cardioplegia following acute myocardial infarction (AMI).
  
  
  METHODS
  We retrospectively reviewed 88 consecutive patients with AMI undergoing coronary artery bypass (CABG) surgery with cardioplegic arrest between June 2010 to June 2012. Patients exclusively received WB (n = 40, June 2010-July 2011) or DN (n = 48, August 2011-June 2012) cardioplegia. Preoperative and postoperative data were retrospectively reviewed and compared using propensity scoring.
  
  
  RESULTS
  No significant difference in age, maximum preoperative serum troponin level, ejection fraction, and STS score was present between DN and WB. A single cardioplegia dose was given in 41 DN vs. 0 WB patients (p < 0.001), and retrograde cardioplegia was used 10 DN vs. 31 WB patients (p < 0.001). Mean cardiopulmonary bypass and cross clamp times were significantly shorter in the DN group versus WB group. Transfusion rate, length of stay, intra-aortic balloon pump requirement, post-operative inotropic support, and 30-day mortality was no different between groups. One patient in the WB group required a mechanical support due to profound cardiogenic shock.
  
  
  CONCLUSIONS
  DN cardioplegia may provide equivalent myocardial protection to existing cardioplegia without negative inotropic effects in the setting of acute myocardial infarction.
authors.forename: Halit
authors.initials: H
authors.lastname: Yerebakan
authors.forename: Robert A
authors.initials: RA
authors.lastname: Sorabella
authors.forename: Marc
authors.initials: M
authors.lastname: Najjar
authors.forename: Estibaliz
authors.initials: E
authors.lastname: Castillero
authors.forename: Linda
authors.initials: L
authors.lastname: Mongero
authors.forename: James
authors.initials: J
authors.lastname: Beck
authors.forename: Maliha
authors.initials: M
authors.lastname: Hossain
authors.forename: Hiroo
authors.initials: H
authors.lastname: Takayama
authors.forename: Mathew R
authors.initials: MR
authors.lastname: Williams
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Naka
authors.forename: Michael
authors.initials: M
authors.lastname: Argenziano
authors.forename: Emile
authors.initials: E
authors.lastname: Bacha
authors.forename: Craig R
authors.initials: CR
authors.lastname: Smith
authors.forename: Isaac
authors.initials: I
authors.lastname: George
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056988:Anterior Wall Myocardial Infarction / Q000601:surgery*; D001803:Blood Transfusion; D002314:Cardioplegic Solutions / Q000008:administration & dosage; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods*; D004334:Drug Administration Schedule; D005260:Female; D006324:Heart Arrest, Induced / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D012449:Safety; D012770:Shock, Cardiogenic / Q000209:etiology; D014336:Troponin / Q000097:blood
chemical_list: D002314:Cardioplegic Solutions; D014336:Troponin