Evaluating the Efficacy of Conventional Crystalloid Cardioplegia Versus Modified Del Nido Cardioplegia in Patients with Multivessel Coronary Artery Disease for CABG surgery

Background: Cardioplegia is crucial in cardiac surgery for myocardial protection. Modified del Nido cardioplegia, initially used in paediatric patients, is now employed in adult cardiac surgeries for its prolonged protection with a single dose. Aim: To compare the efficacy of conventional crystalloid cardioplegia and modified del Nido cardioplegia in patients undergoing coronary artery bypass graft surgery (CABG) for multivessel coronary artery disease (CAD). Methods: A randomized controlled trial included 94 adult patients undergoing elective CABG. Patients were randomly assigned to receive either conventional crystalloid cardioplegia or modified Del Nido cardioplegia. Data collected included CPB and cross-clamp times, cardioplegia volume, postoperative cardiac biomarkers (CK-MB, Troponin I), and clinical outcomes (ICU stay, complications). Results: The modified del Nido cardioplegia group had significantly shorter CPB (mean 92.5±35.94 vs. 105 ±38.3 minutes, p > 0.001) and cross-clamp times (mean 58.3 ±19.86 vs. 63.2 ±18.6 minutes, p > 0.001) and required fewer doses of cardioplegia solution (mean volume 1400 vs. 1500 mL, p < 0.001). Postoperative CK-MB levels were lower in the del Nido group at 1, 12, and 24 hours (p < 0.001), as were Troponin I levels at 24 hours (mean 5.7 ±1.2 vs. 6.2 ±0.7μg/L, p < 0.05). The del Nido group also had shorter ICU stays (mean 2.51 ±0.83 vs. 3.04 ±1.18 days, p < 0.05) and reduced ventilation time (mean 6.59 ±0.65 vs. 6.91 ±0.62 hours, p < 0.05). There were no significant differences in overall hospital stay or postoperative complications between the groups. Conclusion: Modified del Nido cardioplegia offers superior myocardial protection in CABG for multivessel CAD, with shorter operative times, reduced cardiac biomarker levels, and shorter ICU stays, making it a safe and effective alternative for myocardial protection in complex cardiac surgeries.