Comparison between three single-dose cardioplegic solutions in myocardial protection: Cardioplegia Trial – a double-blind randomised clinical trial
Year: 2026
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: OBJECTIVES: To compare myocardial protection afforded by three single-dose cardioplegic solutions - Custodiol (HTK), del Nido (DN) and modified del Nido (MDN) - in adult elective cardiac surgery. DESIGN: Double-blind randomised controlled trial. SETTING: Tertiary hospital in southern Brazil. PARTICIPANTS: 99 adults undergoing elective valve or coronary artery bypass surgery with cardiopulmonary bypass. INTERVENTIONS: Administration of HTK, DN or MDN solution during surgery. MAIN OUTCOME MEASURES: High-sensitivity cardiac troponin T (hs-cTnT) at 0, 2, 12 and 24 hours postoperatively. Additionally, indirect measures of myocardial protection were compared, both laboratory and clinical, during intraoperative and postoperative periods. RESULTS: All solutions provided effective myocardial protection, with similar clinical and laboratory outcomes. DN was associated with significantly lower hs-cTnT at 2 hours (p=0.023) and fewer intraoperative transfusions (p=0.008). HTK patients had lower postoperative sodium and potassium levels (p=0.049 and p=0.002, respectively). Survival and major postoperative outcomes, including vasoactive or mechanical support, were similar across groups. CONCLUSIONS: The three cardioplegic strategies showed comparable biochemical profiles of myocardial injury. DN was associated with lower early troponin release and reduced transfusion requirements, while HTK produced transient electrolyte shifts. TRIAL REGISTRATION NUMBER: ReBEC; RBR-7g5s66.
Source: Heart
Authors: Kathize Betti Lira, Renan Senandes Delvaux, Felipe Abatti Spadini, Fernando Anschau, Luciane Kopittke, Juarez Rode, Rafael Oliveira Ceron, Rafael Antônio Widholzer Rey, Estefania Inez Wittke, Alfeu Roberto Rombaldi, Alexsandro Rodrigues Oliveira, Cristine Lunardi Rodrigues, Carla Helena Pereira, Adriana Silveira Almeida
Institution: Grupo Hospitalar Conceição
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7162697410