Precision and Protection: Advanced Myocardial Preservation in Complex Cardiac Surgery

Custodial-HTK Cardioplegia in Conventional Cardiac Surgery: A Retrospective Analysis From UiTM

February 4, 2026 No Comments

This retrospective cohort study from a Malaysian tertiary cardiac center compares Custodial-HTK cardioplegia with conventional blood cardioplegia in elective on-pump cardiac surgery. Although Custodial-HTK was preferentially used in higher-risk and more complex cases with lower baseline LVEF and longer bypass times, postoperative outcomes, ICU stay, hospital stay, and 30-day mortality were comparable, supporting its safety and effectiveness.

Global Teamwork in Modern Myocardial Protection: Alternative Base Solutions for del Nido Cardioplegia

Alternative Base Solutions for del Nido Cardioplegia: Composition, Rationale, and Clinical Evidence

January 31, 2026 No Comments

This comprehensive review examines alternative crystalloid and whole-blood base solutions for del Nido cardioplegia, including normal saline, lactated Ringer’s, plain Ringer’s, Isolyte S, Ionosteril, and whole blood. Drawing on experimental models, randomized trials, and clinical studies, the article demonstrates that these alternatives provide myocardial protection and postoperative outcomes comparable to Plasma-Lyte A when appropriately buffered, supporting cost-effective and globally accessible cardiac surgery practice.

Active Myocardial Protection During Cardioplegic Arrest

Molecular and Cellular Mechanisms of Cardioplegic Protection in Surgical Myocardial Revascularization

January 31, 2026 No Comments

This comprehensive review explores how cardioplegia actively protects the myocardium during coronary artery bypass grafting. Beyond inducing cardiac arrest, cardioplegic solutions modulate calcium homeostasis, mitochondrial function, oxidative stress, inflammation, and apoptosis. By suppressing electromechanical activity and metabolic demand, cardioplegia prolongs ischemic tolerance and mitigates reperfusion injury, offering critical insights for optimizing myocardial protection strategies in modern cardiac surgery.

Perioperative Bleeding Is Not an Independent Risk Factor for Acute Kidney Injury

Comparable Renal Effects of Histidine-Tryptophan-Ketoglutarate and DelNido Cardioplegia in a Porcine Model of Cardiac Arrest

November 20, 2025 No Comments

This study evaluated the renal impact of two cardioplegic solutions—HTK and DelNido—in pigs undergoing cardiac arrest. Despite DelNido showing better electrolyte and hemoglobin stability, both solutions induced comparable levels of renal injury. Biomarkers (NGAL, FABP-1, cystatin C), histological damage, oxidative/nitrosative stress, and apoptosis indicators revealed no significant differences, supporting similar renal safety profiles during 90-minute cardiac arrest.

The Novel St Thomas’ Hospital Polarizing Blood Cardioplegia: Results in Hearts With Reduced Ejection Fraction

July 13, 2025 No Comments

This study investigates the efficacy of a new St Thomas’ Hospital polarizing cardioplegia (STH-pol) versus standard depolarizing cardioplegia (STH-control) in rats with chronic myocardial infarction. Although STH-pol showed trends toward better coronary flow and reduced myocardial oxygen consumption, no statistically significant difference in myocardial protection was found. Both solutions demonstrated comparable recovery and energy preservation.

Patient Outcomes After Introduction of Novel Myocardial Protection Protocol for Prolonged Aortic Cross-Clamping

June 24, 2025 No Comments

This study evaluates the impact of a revised myocardial protection protocol implemented in 2021 at St. Marianna University School of Medicine for patients undergoing cardiac surgery with prolonged aortic cross-clamping (>4 hours). The revised protocol, focusing on the timing and method of blood cardioplegia administration, led to significantly lower postoperative creatine kinase levels and shorter hospital stays, indicating improved myocardial protection without altering the cardioplegia solution itself.

Del Nido Cardioplegia in Adult Cardiac Surgery: A Narrative Review

May 13, 2025 No Comments

This review explores the use of Del Nido cardioplegia in adult cardiac surgery, originally developed for pediatric use. It outlines its composition, benefits over traditional blood cardioplegia, and its mechanism in protecting the myocardium from ischemia-reperfusion injury. The article compiles data showing its efficacy in reducing cross-clamp times, myocardial injury, and transfusion requirements, with comparable or improved clinical outcomes.

Comparison of Del Nido and Histidine-Tryptophan-Ketoglutarate Cardioplegia Solutions: An Animal Study With Prolonged Ischaemia

April 3, 2025 No Comments

This study compares Del Nido (DN) and Bretschneider histidine-tryptophan-ketoglutarate (HTK) cardioplegia solutions in a porcine model of prolonged ischaemia. DN demonstrated superior left ventricular function, spontaneous return to sinus rhythm, and less haemodilution and endothelial dysfunction compared to HTK. Histological and biochemical markers of injury, stress, and apoptosis showed no significant differences, suggesting DN offers enhanced myocardial protection during cardiac surgery.

Cerebral Inflammation in an Animal Ischemia–Reperfusion Model Comparing Histidine-Tryptophan–Ketoglutarate and Del Nido Cardioplegia

March 30, 2025 No Comments

This study compares two cardioplegic solutions—HTK and Del Nido—for their impact on cerebral inflammation in a porcine cardiopulmonary bypass model. Results showed that while both solutions produced comparable hypoxia and inflammation markers overall, HTK led to more pronounced hyponatremia, hypochloremia, and increased IL-1β mRNA in certain brain regions. Del Nido cardioplegia provided more stable electrolyte levels and less cerebral inflammation.

Buckberg vs. Del Nido in Isolated Aortic Valve Replacement: A Prospective, Two-Center, Randomized Trial

March 16, 2025 No Comments

This study compares Buckberg (BS) and Del Nido (DNS) cardioplegia in isolated aortic valve replacement (AVR) through a two-center randomized trial with 311 patients. While postoperative creatine kinase and troponin levels showed no significant differences, the DNS group had better intraoperative glycemic control, higher spontaneous rhythm rates, and fewer cases of ventricular fibrillation requiring defibrillation. The study supports DNS as a viable alternative with workflow advantages.