Modified Del Nido Cardioplegia and Its Evaluation in a Piglet Model

Mitsutaka Nakao, Kiyozo Morita, Gen Shinohara, Takashi Kunihara

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2 Citations (Scopus)


Del Nido cardioplegia (DN) is not available worldwide as the required solution is made from a commercial base (PlasmaLyte) that is not approved in all countries. We report our own modified DN solution and confirm its safety and effectiveness. Fourteen piglets were subjected to 90 minutes of global ischemia on cardiopulmonary bypass induced by original DN (n = 7) or NS (normal saline)-based DN (n = 7). Our DN solution begins with a base of NS (800 mL) and distilled water (200 mL), to which are added 15 mL KCl (2 mEq/mL), 17 mL NaHCO3 (1 mEq/mL), 10 mL MgSO4 (0.2 g/mL), 13 mL lidocaine 1%, and 13 mL mannitol 25%. LV function recovery was assessed in end-systolic elastance (EES) as systolic function and end-diastolic pressure-volume relationship (EDPVR) as diastolic function using a conductance catheter. Creatine kinase-MB (CK-MB) and mitochondrial score were also measured. Left ventricular (LV) contractility after ischemia (%EES ± SD) was not significantly different between the group induced by original DN (89.3 ± 20.6%) and the group induced by NS-based DN (99.3 ± 18.4%). LV compliance (%EDPVR ± SD) was likewise not significantly different between these groups (102.7 ± 28.2% vs 94.4 ± 22.8%, PL vs NS, respectively). CK-MB was equivalent between the groups. Mitochondrial scores were not significantly different between the groups, and this difference did not cause severe damage. NS-based DN preserves LV function recovery after prolonged global ischemia as effectively and as safely as original DN does. NS-based modified DN can be substituted for original DN.

Original languageEnglish
Pages (from-to)84-92
Number of pages9
JournalSeminars in Thoracic and Cardiovascular Surgery
Issue number1
Publication statusPublished - Mar 1 2021
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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