Del Nido Cardioplegia in Coronary Artery Bypass Grafting Surgery: A safe, efficacious and economic alternative to St. Thomas solution; an experience from a developing nation
Introduction: del Nido cardioplegia is a newer solution getting popular worldwide, whereas in Nepal, St. Thomas cardioplegia solution is conventionally used. There is no national recommendation on cardioplegia solutions supported by evidences from Nepalese studies. This study aimed to evaluate and c...
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| Veröffentlicht in: | Perfusion 2021-07, Vol.36 (5), p.470-475 |
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| creator | Moktan Lama, Purna Bahadur Khakural, Prabhat Sigdel, Shailendra Raj Bhatta, Mahendra Sah Teli, Rabindra Baral, Ravi Kumar Bhattarai, Anil Pradhan, Bishwas Koirala, Bhagawan |
| description | Introduction:
del Nido cardioplegia is a newer solution getting popular worldwide, whereas in Nepal, St. Thomas cardioplegia solution is conventionally used. There is no national recommendation on cardioplegia solutions supported by evidences from Nepalese studies. This study aimed to evaluate and compare the efficacy of these solutions in Nepalese patients undergoing coronary artery bypass grafting.
Methods:
Patients undergoing coronary revascularization, from May 2018 to December 2019, were randomized into St. Thomas and del Nido groups based on the cardioplegia administered, with 45 patients in each group. Preoperative, intraoperative, and postoperative parameters and cost of cardioplegia preparation in the two groups were compared.
Results:
The cardiopulmonary bypass time (106.13 ± 24.65 minutes vs 107.62 ± 18.69 minutes, p = 0.02), aortic cross clamp time (66.22 ± 15.40 minutes vs 72.07 ± 12.23 minutes, p = 0.04), volume (1059.22 ± 100.30 ml vs 1526.67 ± 271.81 ml, p |
| doi_str_mv | 10.1177/0267659121991033 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2483811709</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0267659121991033</sage_id><sourcerecordid>2483811709</sourcerecordid><originalsourceid>FETCH-LOGICAL-c365t-28c232017e7b7a27bcc8efa219b5ec3fb04e987fb21a324b59e688b6c338e1153</originalsourceid><addsrcrecordid>eNp1kU9v1DAQxS0EotvCnRMaiQsHUvwvcQKnZQsFqYJDi8Qtcpzx4iqxg51U9EPxHXG0BaRKnEaa-b03mnmEPGP0lDGlXlNeqapsGGdNw6gQD8iGSaUKxti3h2Szjot1fkSOU7qmlEopxWNyJERJGyrFhvw6wwE-uz7ATsfehWnAvdPgPOxCDF7HW9jGGXN5dzvplOA8ajs7v4fLJe5z_w1sIWmLrwCtdUYbF5YE2veAJvgwOgN6yAZez-4GYQ5wOZ_C1fcw6gQpDMvsgn-bBYA_J4wOvUGwMYygoccbHMK0blvlwT8hj6weEj69qyfk64f3V7uPxcWX80-77UVhRFXOBa8NF5wyhapTmqvOmBqtzl_qSjTCdlRiUyvbcaYFl13ZYFXXXWWEqJGxUpyQlwffKYYfC6a5HV0yOAzaYz6v5bIWdU6ANhl9cQ-9Dku-dshUKXnFGRMsU_RAmRhSimjbKboxf7dltF2jbO9HmSXP74yXbsT-r-BPdhkoDkDSe_y39b-GvwHuhadJ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2542621131</pqid></control><display><type>article</type><title>Del Nido Cardioplegia in Coronary Artery Bypass Grafting Surgery: A safe, efficacious and economic alternative to St. Thomas solution; an experience from a developing nation</title><source>SAGE Publications</source><source>MEDLINE</source><creator>Moktan Lama, Purna Bahadur ; Khakural, Prabhat ; Sigdel, Shailendra ; Raj Bhatta, Mahendra ; Sah Teli, Rabindra ; Baral, Ravi Kumar ; Bhattarai, Anil ; Pradhan, Bishwas ; Koirala, Bhagawan</creator><creatorcontrib>Moktan Lama, Purna Bahadur ; Khakural, Prabhat ; Sigdel, Shailendra ; Raj Bhatta, Mahendra ; Sah Teli, Rabindra ; Baral, Ravi Kumar ; Bhattarai, Anil ; Pradhan, Bishwas ; Koirala, Bhagawan</creatorcontrib><description>Introduction:
del Nido cardioplegia is a newer solution getting popular worldwide, whereas in Nepal, St. Thomas cardioplegia solution is conventionally used. There is no national recommendation on cardioplegia solutions supported by evidences from Nepalese studies. This study aimed to evaluate and compare the efficacy of these solutions in Nepalese patients undergoing coronary artery bypass grafting.
Methods:
Patients undergoing coronary revascularization, from May 2018 to December 2019, were randomized into St. Thomas and del Nido groups based on the cardioplegia administered, with 45 patients in each group. Preoperative, intraoperative, and postoperative parameters and cost of cardioplegia preparation in the two groups were compared.
Results:
The cardiopulmonary bypass time (106.13 ± 24.65 minutes vs 107.62 ± 18.69 minutes, p = 0.02), aortic cross clamp time (66.22 ± 15.40 minutes vs 72.07 ± 12.23 minutes, p = 0.04), volume (1059.22 ± 100.30 ml vs 1526.67 ± 271.81 ml, p < 0.001) and number of cardioplegia doses (1.00 ± 0.00 vs 2.51 ± 0.66, p < 0.001) were significantly lower with del Nido cardioplegia. A lower CPK-MB at second post-operative (59.91 ± 31.62 vs 73.82 ± 37.25, p = 0.03) and a higher left ventricle ejection fraction at discharge (56.33 ± 8.94% vs 50.45 ± 8.55%, p < 0.001) was observed in del Nido group. There was one death in St. Thomas group. ICU and hospital stay were similar in both groups. St. Thomas solution was found to be costlier than del Nido solution (USD 5.40 ± 0.96 vs USD 3.50 ± 0.34, p < 0.001).
Conclusion:
The del Nido cardioplegia was found to be efficacious, safe and more economical alternative to St. Thomas solution.</description><identifier>ISSN: 0267-6591</identifier><identifier>EISSN: 1477-111X</identifier><identifier>DOI: 10.1177/0267659121991033</identifier><identifier>PMID: 33509043</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Aorta ; Cardioplegic Solutions - therapeutic use ; Coronary artery ; Coronary Artery Bypass ; Coronary vessels ; Developing Countries ; Grafting ; Heart Arrest, Induced ; Heart surgery ; Humans ; LDCs ; Patients ; Stroke Volume ; Ventricle</subject><ispartof>Perfusion, 2021-07, Vol.36 (5), p.470-475</ispartof><rights>The Author(s) 2021</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-28c232017e7b7a27bcc8efa219b5ec3fb04e987fb21a324b59e688b6c338e1153</citedby><cites>FETCH-LOGICAL-c365t-28c232017e7b7a27bcc8efa219b5ec3fb04e987fb21a324b59e688b6c338e1153</cites><orcidid>0000-0003-2057-4792 ; 0000-0002-2336-3571 ; 0000-0001-5357-1083</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0267659121991033$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0267659121991033$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33509043$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Moktan Lama, Purna Bahadur</creatorcontrib><creatorcontrib>Khakural, Prabhat</creatorcontrib><creatorcontrib>Sigdel, Shailendra</creatorcontrib><creatorcontrib>Raj Bhatta, Mahendra</creatorcontrib><creatorcontrib>Sah Teli, Rabindra</creatorcontrib><creatorcontrib>Baral, Ravi Kumar</creatorcontrib><creatorcontrib>Bhattarai, Anil</creatorcontrib><creatorcontrib>Pradhan, Bishwas</creatorcontrib><creatorcontrib>Koirala, Bhagawan</creatorcontrib><title>Del Nido Cardioplegia in Coronary Artery Bypass Grafting Surgery: A safe, efficacious and economic alternative to St. Thomas solution; an experience from a developing nation</title><title>Perfusion</title><addtitle>Perfusion</addtitle><description>Introduction:
del Nido cardioplegia is a newer solution getting popular worldwide, whereas in Nepal, St. Thomas cardioplegia solution is conventionally used. There is no national recommendation on cardioplegia solutions supported by evidences from Nepalese studies. This study aimed to evaluate and compare the efficacy of these solutions in Nepalese patients undergoing coronary artery bypass grafting.
Methods:
Patients undergoing coronary revascularization, from May 2018 to December 2019, were randomized into St. Thomas and del Nido groups based on the cardioplegia administered, with 45 patients in each group. Preoperative, intraoperative, and postoperative parameters and cost of cardioplegia preparation in the two groups were compared.
Results:
The cardiopulmonary bypass time (106.13 ± 24.65 minutes vs 107.62 ± 18.69 minutes, p = 0.02), aortic cross clamp time (66.22 ± 15.40 minutes vs 72.07 ± 12.23 minutes, p = 0.04), volume (1059.22 ± 100.30 ml vs 1526.67 ± 271.81 ml, p < 0.001) and number of cardioplegia doses (1.00 ± 0.00 vs 2.51 ± 0.66, p < 0.001) were significantly lower with del Nido cardioplegia. A lower CPK-MB at second post-operative (59.91 ± 31.62 vs 73.82 ± 37.25, p = 0.03) and a higher left ventricle ejection fraction at discharge (56.33 ± 8.94% vs 50.45 ± 8.55%, p < 0.001) was observed in del Nido group. There was one death in St. Thomas group. ICU and hospital stay were similar in both groups. St. Thomas solution was found to be costlier than del Nido solution (USD 5.40 ± 0.96 vs USD 3.50 ± 0.34, p < 0.001).
Conclusion:
The del Nido cardioplegia was found to be efficacious, safe and more economical alternative to St. Thomas solution.</description><subject>Aorta</subject><subject>Cardioplegic Solutions - therapeutic use</subject><subject>Coronary artery</subject><subject>Coronary Artery Bypass</subject><subject>Coronary vessels</subject><subject>Developing Countries</subject><subject>Grafting</subject><subject>Heart Arrest, Induced</subject><subject>Heart surgery</subject><subject>Humans</subject><subject>LDCs</subject><subject>Patients</subject><subject>Stroke Volume</subject><subject>Ventricle</subject><issn>0267-6591</issn><issn>1477-111X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU9v1DAQxS0EotvCnRMaiQsHUvwvcQKnZQsFqYJDi8Qtcpzx4iqxg51U9EPxHXG0BaRKnEaa-b03mnmEPGP0lDGlXlNeqapsGGdNw6gQD8iGSaUKxti3h2Szjot1fkSOU7qmlEopxWNyJERJGyrFhvw6wwE-uz7ATsfehWnAvdPgPOxCDF7HW9jGGXN5dzvplOA8ajs7v4fLJe5z_w1sIWmLrwCtdUYbF5YE2veAJvgwOgN6yAZez-4GYQ5wOZ_C1fcw6gQpDMvsgn-bBYA_J4wOvUGwMYygoccbHMK0blvlwT8hj6weEj69qyfk64f3V7uPxcWX80-77UVhRFXOBa8NF5wyhapTmqvOmBqtzl_qSjTCdlRiUyvbcaYFl13ZYFXXXWWEqJGxUpyQlwffKYYfC6a5HV0yOAzaYz6v5bIWdU6ANhl9cQ-9Dku-dshUKXnFGRMsU_RAmRhSimjbKboxf7dltF2jbO9HmSXP74yXbsT-r-BPdhkoDkDSe_y39b-GvwHuhadJ</recordid><startdate>202107</startdate><enddate>202107</enddate><creator>Moktan Lama, Purna Bahadur</creator><creator>Khakural, Prabhat</creator><creator>Sigdel, Shailendra</creator><creator>Raj Bhatta, Mahendra</creator><creator>Sah Teli, Rabindra</creator><creator>Baral, Ravi Kumar</creator><creator>Bhattarai, Anil</creator><creator>Pradhan, Bishwas</creator><creator>Koirala, Bhagawan</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2057-4792</orcidid><orcidid>https://orcid.org/0000-0002-2336-3571</orcidid><orcidid>https://orcid.org/0000-0001-5357-1083</orcidid></search><sort><creationdate>202107</creationdate><title>Del Nido Cardioplegia in Coronary Artery Bypass Grafting Surgery: A safe, efficacious and economic alternative to St. Thomas solution; an experience from a developing nation</title><author>Moktan Lama, Purna Bahadur ; Khakural, Prabhat ; Sigdel, Shailendra ; Raj Bhatta, Mahendra ; Sah Teli, Rabindra ; Baral, Ravi Kumar ; Bhattarai, Anil ; Pradhan, Bishwas ; Koirala, Bhagawan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-28c232017e7b7a27bcc8efa219b5ec3fb04e987fb21a324b59e688b6c338e1153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aorta</topic><topic>Cardioplegic Solutions - therapeutic use</topic><topic>Coronary artery</topic><topic>Coronary Artery Bypass</topic><topic>Coronary vessels</topic><topic>Developing Countries</topic><topic>Grafting</topic><topic>Heart Arrest, Induced</topic><topic>Heart surgery</topic><topic>Humans</topic><topic>LDCs</topic><topic>Patients</topic><topic>Stroke Volume</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Moktan Lama, Purna Bahadur</creatorcontrib><creatorcontrib>Khakural, Prabhat</creatorcontrib><creatorcontrib>Sigdel, Shailendra</creatorcontrib><creatorcontrib>Raj Bhatta, Mahendra</creatorcontrib><creatorcontrib>Sah Teli, Rabindra</creatorcontrib><creatorcontrib>Baral, Ravi Kumar</creatorcontrib><creatorcontrib>Bhattarai, Anil</creatorcontrib><creatorcontrib>Pradhan, Bishwas</creatorcontrib><creatorcontrib>Koirala, Bhagawan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Perfusion</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Moktan Lama, Purna Bahadur</au><au>Khakural, Prabhat</au><au>Sigdel, Shailendra</au><au>Raj Bhatta, Mahendra</au><au>Sah Teli, Rabindra</au><au>Baral, Ravi Kumar</au><au>Bhattarai, Anil</au><au>Pradhan, Bishwas</au><au>Koirala, Bhagawan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Del Nido Cardioplegia in Coronary Artery Bypass Grafting Surgery: A safe, efficacious and economic alternative to St. Thomas solution; an experience from a developing nation</atitle><jtitle>Perfusion</jtitle><addtitle>Perfusion</addtitle><date>2021-07</date><risdate>2021</risdate><volume>36</volume><issue>5</issue><spage>470</spage><epage>475</epage><pages>470-475</pages><issn>0267-6591</issn><eissn>1477-111X</eissn><abstract>Introduction:
del Nido cardioplegia is a newer solution getting popular worldwide, whereas in Nepal, St. Thomas cardioplegia solution is conventionally used. There is no national recommendation on cardioplegia solutions supported by evidences from Nepalese studies. This study aimed to evaluate and compare the efficacy of these solutions in Nepalese patients undergoing coronary artery bypass grafting.
Methods:
Patients undergoing coronary revascularization, from May 2018 to December 2019, were randomized into St. Thomas and del Nido groups based on the cardioplegia administered, with 45 patients in each group. Preoperative, intraoperative, and postoperative parameters and cost of cardioplegia preparation in the two groups were compared.
Results:
The cardiopulmonary bypass time (106.13 ± 24.65 minutes vs 107.62 ± 18.69 minutes, p = 0.02), aortic cross clamp time (66.22 ± 15.40 minutes vs 72.07 ± 12.23 minutes, p = 0.04), volume (1059.22 ± 100.30 ml vs 1526.67 ± 271.81 ml, p < 0.001) and number of cardioplegia doses (1.00 ± 0.00 vs 2.51 ± 0.66, p < 0.001) were significantly lower with del Nido cardioplegia. A lower CPK-MB at second post-operative (59.91 ± 31.62 vs 73.82 ± 37.25, p = 0.03) and a higher left ventricle ejection fraction at discharge (56.33 ± 8.94% vs 50.45 ± 8.55%, p < 0.001) was observed in del Nido group. There was one death in St. Thomas group. ICU and hospital stay were similar in both groups. St. Thomas solution was found to be costlier than del Nido solution (USD 5.40 ± 0.96 vs USD 3.50 ± 0.34, p < 0.001).
Conclusion:
The del Nido cardioplegia was found to be efficacious, safe and more economical alternative to St. Thomas solution.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>33509043</pmid><doi>10.1177/0267659121991033</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-2057-4792</orcidid><orcidid>https://orcid.org/0000-0002-2336-3571</orcidid><orcidid>https://orcid.org/0000-0001-5357-1083</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | Perfusion, 2021-07, Vol.36 (5), p.470-475 |
| issn | 0267-6591 1477-111X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2483811709 |
| source | SAGE Publications; MEDLINE |
| subjects | Aorta Cardioplegic Solutions - therapeutic use Coronary artery Coronary Artery Bypass Coronary vessels Developing Countries Grafting Heart Arrest, Induced Heart surgery Humans LDCs Patients Stroke Volume Ventricle |
| title | Del Nido Cardioplegia in Coronary Artery Bypass Grafting Surgery: A safe, efficacious and economic alternative to St. Thomas solution; an experience from a developing nation |
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