Experience in the Use of del Nido Cardioplegia in Ramathibodi Hospital
Narongrit Kantathut MD*, Chaliow Shaishana CCP*, Wanrudee Thongcherd CCP*, Wilailak Sornprasit CCP*, Sumethee Jiraratkul CCP*, Suthit Vilaikan CCP*, Panwasa Krailest CCP*, Parinya Leelayana MD*, Piya Cherntanomwong MD*, Siam Khajarern MD*
Affiliation : * Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Background : del Nido cardioplegia is an extracellular, single-dose, non-calcium cardioplegic solution that has been increas-
ing in popularity for the last decade. Plasma-Lyte A, the main base solution is not available in Thailand. We hypothesized that
lactated Ringer solution can safely replace Plasma-Lyte A as the main carrier for del Nido cardioplegia.
Objective : To report early results using lactated Ringer solution as a main carrier for del Nido cardioplegia.
Material and Method: All patients undergoing cardiac surgery with del Nido cardioplegia between December 2016 and May
2017 were reviewed. Preoperative, intraoperative, and postoperative outcomes were collected and analyzed.
Results : Mean age was 51.48+20.58 years, and 57.14% were male. Mean STS score was 3.01+3.10. Total cardioplegia use
was 1,207.43+380.93 ml. Number of cardioplegia given was 1.66+0.72 times. Aortic cross clamp time and total bypass time
were 108.51+48.60 mins and 145.63+55.63 mins, respectively. Ventricular fibrillation after aortic cross clamp removal
occurred in four patients (11.43%). ICU stay and hospital stay were 1.94+1.15 days and 8.06+7.57 days, respectively. New
onset of atrial fibrillation occurred in six patients (17.14%). Complications occurred in one patient (2.86%) (acute kidney
injury). There was one case of mortality (2.86%) was observed.
Conclusion : Lactated Ringer solution can be used safely to replace the crystalloid component of del Nido cardioplegia,
Plasma-Lyte A, with an acceptable result.
Keywords : del Nido cardioplegia, Lactated ringer solution, Myocardial protection
