Saline-based modified del Nido cardioplegia versus multidose St. Thomas cardioplegia in canine mitral valve repair: A randomized controlled trial.

Abstract

OBJECTIVE: To compare the utility of a saline-based modified del Nido (mDN) cardioplegia solution with a conventional institutional technique (multidose St. Thomas blood cardioplegia) for mitral valve repair (MVR) in dogs. STUDY DESIGN: Prospective, randomized, open-label trial. ANIMALS: Forty client-owned dogs with myxomatous mitral valve disease (stage B2 and C) eligible for MVR were divided into control and modified mDN groups. METHODS: Cardioplegia was induced in the control group using 50% blood containing St. Thomas solution every 10&#x2009;min. In the mDN group, a cardioplegia solution containing 20% blood was administered once or when required. As the primary outcome, serum cardiac troponin I levels were compared 12&#x2009;h postoperatively between the groups. The other clinical findings were evaluated as secondary outcomes. RESULTS: Troponin levels 12&#x2009;h after surgery were a median of 27.8&#x2009;ng/mL (interquartile range, 15.1-43.2) in the control group and 19.4&#x2009;ng/mL (15.2-33.6) in the mDN group (p&#x2009;=&#x2009;.478). The sinus rhythm recovery time following aortic cross-clamp removal was 362&#x2009;s (103-995) in the control group and 60&#x2009;s (44-605) in the mDN group (p&#x2009;=&#x2009;.027). The total amount of crystalloid cardioplegia solution required was 12.6&#x2009;mL/kg (11.3-15.0) in the control group and 23.6&#x2009;mL/kg (18.0-35.1) in the mDN group (p&#x2009;<&#x2009;.001). CONCLUSION: Cardiac troponin I levels did not show differences between the groups. The saline-based mDN cardioplegia facilitated earlier sinus rhythm recovery. CLINICAL SIGNIFICANCE: Saline-based mDN cardioplegia may be a viable alternative for canine MVR.