94% of researchers rate our articles as excellent or good
Learn more about the work of our research integrity team to safeguard the quality of each article we publish.
Find out more
ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiovascular Surgery
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1448310
Single-dose Modified Bloodless del Nido Cardioplegia for Minimally Invasive Cardiac Surgery
Provisionally accepted- 1 Bucheon Sejong Hospital, Bucheon-si, Republic of Korea
- 2 Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
- 3 Asan Medical Center, Seoul, Republic of Korea
Background: Recent studies demonstrated satisfactory results of del Nido cardioplegia in minimally invasive cardiac surgery (MICS). We aimed to evaluate the efficacy of our modified ‘bloodless’ del Nido cardioplegia in MICS compared to the histidine-tryptophan-ketoglutarate (HTK) solution.Methods: We retrospectively reviewed 471 patients who underwent minimally invasive cardiac surgery (MICS) in our institution between January 2015 and September 2022. Patients were divided into HTK (n = 96) and bloodless del Nido (n = 375) groups. Using propensity score matching, we matched 72 patients with bloodless del Nido to 72 patients with HTK, based on demographic and operative information.Results: There were no significant differences in the baseline characteristics and operative data after matching. The early mortality and morbidities did not differ significantly between the two groups. Freedom from overall mortality did not differ significantly during the follow-up period (97.2% in HTK vs. 98.6 in bloodless del Nido at 2 years, P = 0.56). The two groups had no difference in postoperative lactate levels at 6 and 24 hours. Various statistical methods consistently indicated that bloodless del Nido cardioplegia did not increase risks for overall mortality.Conclusions: The modified bloodless del Nido cardioplegia showed comparable postoperative outcomes in MICS compared with the HTK solution, suggesting its potential as an alternative option for MICS.
Keywords: cardioplegia, HTK solution, del Nido cardioplegia solution, Minimally invasive cardiac surgery, Myocardial protection
Received: 13 Jun 2024; Accepted: 12 Feb 2025.
Copyright: © 2025 Lee, Kim and Yoo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jae Suk Yoo, Asan Medical Center, Seoul, Republic of Korea
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.