Comparative Effectiveness of Crystalloid and Blood-Based del Nido Cardioplegia in Children with Septal Congenital Heart Defects
Abstract
Aim. To assess the frequency of myocardial ischemic injury in young children with septal congenital heart defects (CHDs) undergoing open-heart surgery, depending on the method of cardioplegic protection.
Materials and methods. A prospective study included 95 patients aged 1 to 3 years who underwent surgery under cardiopulmonary bypass at the National Children’s Medical Center. Patients were divided into two groups: the control group (n = 42) received crystalloid pharmacohypothermic cardioplegia (CC), and the study group (n = 53) received modified blood-based del Nido cardioplegia.
Results. Troponin I levels at 6 and 24 hours postoperatively, ejection fraction, mechanical ventilation duration, and ICU stay were the main outcome measures. Elevated troponin I 10 times the upper limit of normal was observed in 31.3% of the del Nido group and 62.5% of the CC group (p < 0.001). Ejection fraction decreased by 30.7% in the CC group and by 18% in the del Nido group at 24 hours post-surgery.
Conclusion. Blood-based del Nido cardioplegia provides superior myocardial protection and reduces the incidence of myocardial injury in the early postoperative period in children with CHDs.
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