Original scientific paper

https://doi.org/10.20471/acc.2025.64.03.16

Anterograde vs Antero-/Retrograde del Nido Cardioplegia in Aortic Valve Surgery

Nail Šehić ; Cardiovascular Surgery Clinic, University Clinical Center Tuzla, Bosnia and Herzegovina *
Dragan Piljić ; Cardiovascular Surgery Clinic, University Clinical Center Tuzla, Bosnia and Herzegovina
Emin Grbić ; Department of Physiology, Faculty of Medicine, University of Tuzla, Bosnia and Herzegovina
Alen Hajdarević ; Cardiovascular Surgery Clinic, University Clinical Center Tuzla, Bosnia and Herzegovina
Mugdim Bajrić ; Interventional Cardiology Clinic, University Clinical Center Tuzla, Bosnia and Herzegovina

* Corresponding author.

Abstract

Background: Myocardial protection involves different methods aimed at preventing
or reducing ischemia-reperfusion damage to the myocardium during surgery to preserve postoperative
heart function.
Methods: This study included 100 adult patients undergoing primary isolated elective surgery for aortic
valve stenosis. They were divided into two groups of 50 participants: the experimental group received
the del Nido cardioplegic solution antero-retrogradely and the control group received it anterogradely.
Results: The results in the experimental group showed a statistically significant difference in the
values of Na+, Ca++ and K+ parameters when comparing values intraoperatively and postoperatively. In
the control group, a statistically significant difference (P < 0.001) was observed in the values of parameters
for Na+, K+, Ca++ and left ventricular ejection fraction (LVEF) intraoperatively and postoperatively.
In the control group, intraoperative dobutamine use was 8.5 times higher (95% CI: 2.02-75.85) than
postoperative dobutamine use. Also, intraoperative use was 5 times higher compared to the experimental
group (95% CI: 2.38-14.16). As for norepinephrine, intraoperative use was 4.5 times higher (95% CI:
1.48–18.28) and 3.8 times higher (95% CI: 1.37–13.02) than postoperative use in the experimental
group and the control group, respectively. The incidence of heart rhythm disturbances in the control
group was 10 times higher (95% CI: 1.42-433.97) postoperatively than intraoperatively.
Conclusion: This study indicates that the application of the del Nido cardioplegic solution using both
methods (antero-retrograde) in patients undergoing isolated aortic valve stenosis surgery offers a higher
level of myocardial protection compared to the sole anterograde application of del Nido cardioplegia.

Keywords

cardioplegia; aortic valve; anterograde; retrograde

Hrčak ID:

342942

URI

https://hrcak.srce.hr/342942

Publication date:

30.9.2025.

Article data in other languages: croatian

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