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The Journal of Cardiovascular Surgery 2021 Jun 09

DOI: 10.23736/S0021-9509.21.11710-0

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

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


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BACKGROUND: The evidence regarding the impact of patient’s age and gender on del Nido cardioplegia cadioprotection 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= .168), 48-hour CK-MB (6.19; 4.22-7.71 ng/mL vs 6.07;4.56-7.06 ng/mL; p= .707), 24-hour hs-TnT (259.2; 172.0-376.9 pg/mL vs 193.0; 167.8-351 pg/mL.1; p= .339), 48-hour hs-TnT (169.1; 124.9-293.0 pg/mL vs 159.2; 123.12-211.77 pg/mL; p= .673), VF during reperfusion (25% vs 18,5%; p= .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=.039). Probit regression failed to reveal the impact of patients’ age on post-clamp VF occurrence ( p=.11) or electrical activity during arrest (p=.57) .
CONCLUSIONS: Basing on study results, it can be hypothesised that the del Nido cardioplegia provides adequate myocardial protection in AVR patients regardless of age and gender.


KEY WORDS: Cardioplegia; Del Nido; Age; Gender; Aortic

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