Del Nido cardioplegia offers equivalent myocardial protection and clinical outcomes to blood cardioplegia in adult isolated CABG and valve patients, but the safety and efficacy of del Nido in complex cases with prolonged aortic cross-clamp times is still unknown. 443 patients at our center underwent replacement of the ascending aorta using either del Nido (n = 182) or blood (n = 261) cardioplegia. Two surgeons used del Nido exclusively and 6 used blood exclusively over the study period. Propensity matching of preoperative characteristics yielded 172 well matched pairs. Emergency and reoperative cases were included. Clinical data were extracted from our local database. Troponin levels were drawn at 12 hours postop in all patients. Rates of perioperative mortality (4.7% vs 5.2%), stroke (5.8% vs 7.0%), renal failure (11.6% vs 12.2%), atrial fibrillation (36.0% vs 31.4%), intra-aortic balloon pump insertion (2.3% vs1.2%), and extra corporeal membrane oxygenation use (4.7% vs 4.1%) did not differ between blood and del Nido groups. Postop Troponin T levels were 0.50[0.35, 0.86] ng/mL and 0.40[0.20, 0.70] ng/mL for blood and del Nido, respectively (P < 0.0001). Postop echocardiography was available in 333 of 344 (96.8%) patients, and there was no difference in change in EF from pre- to postop between blood 0.0[-6.0, 5.0]% and del Nido 0.0 [-6.0, 3.5]% (P = 0.201). Subgroup analysis of patients with aortic cross-clamp time greater than 180 minutes (blood = 77, del Nido = 27) revealed no difference in troponins, ejection fraction, or clinical outcomes. Five-year survival was 85.9[76.8, 91.7]% and 79.8[71.2, 86.1]% for blood and del Nido, respectively (P = 0.151). In ascending aortic surgery with prolonged operative times, no differences were observed in myocardial protection or clinical outcomes with the use of del Nido cardioplegia compared to blood cardioplegia.

Del Nido 心脏停搏液提供同等的心肌保护成人孤立性 CABG 和瓣膜患者的血液心脏停搏液的临床结果，但 del Nido 在主动脉阻断时间延长的复杂病例中的安全性和有效性仍然未知。我们中心的 443 名患者使用 del Nido (n = 182) 或血液 (n = 261) 心脏停搏液进行了升主动脉置换术。在研究期间，两名外科医生只使用 del Nido，另外 6 名外科医生只使用血液。术前特征的倾向匹配产生了 172 个匹配良好的对。包括急诊和再手术病例。临床数据是从我们的本地数据库中提取的。在所有患者术后 12 小时绘制肌钙蛋白水平。围手术期死亡率（4.7% 对 5.2%）、中风（5.8% 对 7.0%）、肾功能衰竭（11.6% 对 12.2%）、心房颤动（36.0% 对 31.4%）、主动脉内球囊泵插入（2.体外膜氧合使用（4.7% 对 4.1%）在血液组和 del Nido 组之间没有差异。血液和 del Nido 的术后肌钙蛋白 T 水平分别为 0.50[0.35, 0.86] ng/mL 和 0.40[0.20, 0.70] ng/mL ( P < 0.0001)。344 名患者中有 333 名 (96.8%) 患者进行了术后超声心动图检查，血液 0.0[-6.0, 5.0]% 和 del Nido 0.0 [-6.0, 3.5]% 之间的 EF 从术前到术后的变化没有差异（P  = 0.201）。主动脉阻断时间超过 180 分钟（血液 = 77，del Nido = 27）的患者的亚组分析显示肌钙蛋白、射血分数或临床结果没有差异。血液和 del Nido 的五年生存率分别为 85.9[76.8, 91.7]% 和 79.8[71.2, 86.1]%（P = 0.151）。在手术时间延长的升主动脉手术中，与血液心脏停搏液相比，使用 del Nido 心脏停搏液在心肌保护或临床结果方面没有差异。