Document Type
Article
Publication Date
3-17-2026
Abstract
- A. Background/Introduction: Del Nido cardioplegia was originally developed for pediatric cardiac surgery to provide prolonged myocardial protection with a single-dose strategy. Its adoption in adult cardiac surgery has led to multiple modified formulations, including whole-blood, concentrated, and bloodless strategies. Given expanding clinical use and variation in technique, a structured mapping of the adult evidence base is warranted.
- B. Methodology: This scoping review followed PRISMA-ScR guidance. PubMed and CINAHL were searched, yielding 88 records. After duplicate removal and screening, 18 studies met inclusion criteria. Data were charted on study design, cardioplegia formulation, patient population, myocardial biomarkers, arrhythmias, renal outcomes, transfusion requirements, and mortality.
- C. Results: Across randomized and observational studies, modified del Nido cardioplegia demonstrated myocardial protection comparable to conventional cardioplegia strategies. Whole-blood approaches were associated with reduced hemodilution and transfusion requirements, while bloodless and micro-dose strategies were feasible in minimally invasive and isolated valve procedures. Mortality and major morbidity were generally similar across strategies.
- D. Discussion/Conclusions: Modified del Nido cardioplegia appears safe and effective for adult cardiac surgery. However, heterogeneity in formulations and study design limits definitive comparative conclusions and highlights the need for standardized multicenter trials.
- E. Keywords: del Nido cardioplegia, modified del Nido, whole-blood cardioplegia, concentrated del Nido, alternative-base cardioplegia, micro-dose cardioplegia, bloodless cardioplegia, adult cardiac surgery, coronary artery bypass grafting (CABG), valve surgery, minimally invasive cardiac surgery, myocardial protection, troponin, CK-MB, arrhythmia, defibrillation, renal outcomes, transfusion requirements, cardiopulmonary bypass, ischemia–reperfusion injury
Recommended Citation
Iulianelli, Christian, "Whole-Blood, Concentrated, and Micro–Dose del Nido Cardioplegia in Adult Cardiac Surgery: A Scoping Review" (2026). Student Works. 11.
https://digitalcollections.lipscomb.edu/cper_student/11
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Included in
Cardiology Commons, Cardiovascular System Commons, Surgical Procedures, Operative Commons