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

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 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 h postoperatively between the groups. The other clinical findings were evaluated as secondary outcomes.

RESULTS

Troponin levels 12 h after surgery were a median of 27.8 ng/mL (interquartile range, 15.1-43.2) in the control group and 19.4 ng/mL (15.2-33.6) in the mDN group (p = .478). The sinus rhythm recovery time following aortic cross-clamp removal was 362 s (103-995) in the control group and 60 s (44-605) in the mDN group (p = .027). The total amount of crystalloid cardioplegia solution required was 12.6 mL/kg (11.3-15.0) in the control group and 23.6 mL/kg (18.0-35.1) in the mDN group (p < .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.