OBJECTIVE

To evaluate the efficacy of intraoperative myocardial protection with Del Nido cardioplegia in patients with severe myocardial hypertrophy following severe aortic stenosis and obstructive hypertrophic cardiomyopathy (HCM).

MATERIAL AND METHODS

The study included 225 patients with myocardial hypertrophy who underwent cardiac surgery between January 2020 and July 2023: 150 patients (66.7%) underwent septal myectomy for HCM, 75 (33.3%)%) ones — aortic valve replacement for severe aortic stenosis. Del Nido cardioplegia was used for intraoperative myocardial protection in all patients. We analyzed perioperative complications, mortality, length of hospital-stay, histological findings and markers of myocardial damage.

RESULTS

Aortic cross-clamping time was 63.5±15.9 min (44—90), cardiopulmonary bypass time — 85.1±12.3 min (65—105). There was no early postoperative mortality or acute heart failure requiring mechanical circulatory support. Maximum concentrations of troponin I were observed 2 hours after cardiopulmonary bypass — 2.5±1.5 ng/ml; concentration decreased to 1.7±1.1 ng/ml in 12 and 24 hours after admission to the intensive care unit. Mean ICU-stay was 1.5±0.8 days, postoperative hospital-stay — 6.9±1.5 days.

CONCLUSION

Del Nido cardioplegia can be successfully used in patients with myocardial hypertrophy resulting from valvular defects and hypertrophic cardiomyopathy.