ORIGINAL ARTICLE  CARDIAC SECTION 

The Journal of Cardiovascular Surgery 2021 October;62(5):502-9

DOI: 10.23736/S0021-9509.21.11710-0

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Age- and gender-related differences in the del Nido cardioprotection protocol

Krzysztof SANETRA ^{1, 2} ✉, Wojciech DOMARADZKI ², Marek CISOWSKI ³, Krzysztof BIAŁEK ², Rajesh SHRESTHA ², Andrzej BOCHENEK ^{2, 4, 5}, Justyna JANKOWSKA-SANETRA ⁶, Piotr P. BUSZMAN ^{1, 5, 6}, Witold GERBER ²

¹ Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Kakow University, Krakow, Poland; ² Department of Cardiac Surgery, American Heart of Poland, Bielsko-Biała, Poland; ³ Department of Cardiac Surgery, Clinical University Hospital, Opole, Poland; ⁴ Faculty of Medicine, University of Technology, Katowice, Poland; ⁵ Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland; ⁶ Department of Cardiology, American Heart of Poland, Bielsko-Biała, Poland

BACKGROUND: The evidence regarding the impact of patient’s age and gender on del Nido cardioplegia cadio-protection capability in adults is strongly limited.
METHODS: A group of 75 patients undergoing aortic valve replacement (AVR) with del Nido cardioplegia was divided into Group 1 (male) and Group 2 (female). Creatine kinase (CK-MB isoenzyme) and high sensitivity troponin T (hs-TnT) values at 24 hours and 48 hours, occurrence of cardiac activity during crossclamp and ventricular fibrillation (VF) during reperfusion were compared. The impact of age on hs-TnT,CK-MB, VF during reperfusion and cardiac activity during crossclamp was investigated using regression models.
RESULTS: No difference between the groups was reported in 24-hour CK-MB (median 15.57 ng/mL; IQR 12.13-22.82 ng/mL vs. 13.97; 12.09-17.147 ng/mL; P=0.168), 48-hour CK-MB (6.19; 4.22-7.71 ng/mL vs. 6.07;4.56-7.06 ng/mL; P=0.707), 24-hour hs-TnT (259.2; 172.0-376.9 pg/mL vs. 193.0; 167.8-351 pg/mL.1; P=0.339), 48-hour hs-TnT (169.1; 124.9-293.0 pg/mL vs. 159.2; 123.12-211.77 pg/mL; P=0.673), VF during reperfusion (25% vs. 18,5%; P=0.774) and cardiac activity during arrest (39.6% vs. 37.1%; p= 1.0). Values of CK-MB at 24 hours, hs-TnT at 24 hours and hs-TnT at 48 hours were not dependent on age. The CK-MB at 48 hours was dependent on age (P=0.039). Probit regression failed to reveal the impact of patients’ age on postclamp VF occurrence (P=0.11) or electrical activity during arrest (P=0.57).
CONCLUSIONS: Considering our study results, it can be hypothesized that the del Nido cardioplegia provides adequate myocardial protection in AVR patients regardless of age and gender.

KEY WORDS: Heart arrest, induced; Del Nido cardioplegia solution; Age groups; Aorta