Associazione Nazionale Medici Cardiologi Ospedalieri



Del Nido vs Servator H Cardioplegia

Rosciano Antonio Firenze (Firenze) – Aou Careggi | Paduvakis Iorgos Firenze (Firenze) – Aou Careggi | Cerillo Alfredo Giuseppe Firenze (Firenze) – Aou Careggi | Stefano Pier Luigi Firenze (Firenze) – Aou Careggi

Background and aim. One-shot long-lasting cardioplegia is particularly useful during right minithoracotomy mitral valve surgery (RT-MS), and the Servator H cristalloid solution has been widely used in this setting. However, the Servator H cardioplegia requires the administration of large volumes of fluids and the frequent recourse to ultrafiltration. we compared Servator H versus the Del Nido Cardioplegia, that contains blood and requires smaller volumes, in patients undergoing RT-MS.

Methods. 36 consecutive patients undergoing RT-MS (± tricuspid and AF surgery) were randomly assigned to receive Servator H or Del Nido Cardioplegia. There were no differences between the two groups at baseline.

Results: Although there were no differences in terms of mortality and incidence of major complications, the use of Servator H cardioplegia was associated with a significantly increased release of CK-MB (but not of TnI) during the early postoperative period. Moreover, patients receiving Servator H were more likely to require defibrillation or pacing after removal of the aortic cross-clamp (8, 40%  vs 2, 12.5%), and experienced a significantly higher rate of postoperative atrial fibrillation (10, 50% vs 4, 25%, p < 0.05).

Conclusion: Our data show that the Del Nido cardioplegia could offer improved myocardial protection during minimally invasive mitral valve surgery, resulting in reduced need for post-cardioplegia defibrillation and of postoperative atrial fibrillation. This is consistent with the results of similar, recent research. Further studies on larger populations are needed to consolidate these data.