Medical Design and Outsourcing

  • Home
  • Medical Device Business
    • Mergers & Acquisitions
    • Financial
    • Regulatory
  • Applications
    • Cardiovascular
    • Devices
    • Imaging
    • Implantables
    • Medical Equipment
    • Orthopedic
    • Surgical
  • Technologies
    • Supplies and Components Index
    • Contract Manufacturing
    • Components
    • Electronics
    • Extrusions
    • Materials
    • Motion Control
    • Prototyping
    • Pumps
    • Tubing
  • MedTech Resources
    • Medtech Events in 2025
    • The 2024 Medtech Big 100
    • Medical Device Handbook
    • MedTech 100 Index
    • Subscribe to Print Magazine
    • DeviceTalks
    • Digital Editions
    • eBooks
    • Manufacturer Search
    • Podcasts
    • Print Subscription
    • Webinars / Digital Events
    • Whitepapers
    • Voices
    • Video
  • 2025 Leadership
    • 2024 Winners
    • 2023 Winners
    • 2022 Winners
    • 2021 Winners
  • Women in Medtech
  • Advertise
  • Subscribe

Some Cardiolegia Solutions Offer Pediatric Heart Surgery Patients Better Outcomes

May 16, 2016 By American Association for Thoracic Surgery

During heart surgery, it is sometimes necessary to temporarily stop cardiac activity, a process known as cardioplegia. Specific myocardial protection techniques are necessary for pediatric use. At the 96th AATS Annual Meeting, cardiac surgeons present the results of a prospective, randomized trial of pediatric heart surgery patients that shows that the del Nido cardioplegia solution, a new, long-acting agent, offers significant advantages over conventional cardioplegia, including reduced cardiopulmonary bypass and aortic cross-clamp times and faster onset of action.

“Overall, del Nido cardioplegic solution is a simple and safe cardioprotective strategy. Cardiac performance is satisfactory in the postoperative period with a better cardiac index profile, lesser troponin-I release, and decreased morbidity,” explained Sachin Talwar, MCh, of the Department of Cardiothoracic and Vascular Surgery at the All India Institute of Medical Sciences (New Delhi, India).

The del Nido solution was first proposed by researchers at the University of Pittsburgh in 1990. It offers several advantages, including prolonged action with single dose administration, which helps to avoid the harmful effects of dose repetition. It also contains lidocaine to slow down energy consumption and calcium-competing ions like magnesium to prevent damaging intracellular build-up of calcium. In practice, it can be given as a single dose through the aortic root. In comparison, the conventional method of cardioplegia tested was St. Thomas cold blood cardioplegia. This requires an initial dose of solution, followed by repeated dosing at 25-30 minute intervals during surgery.

In the first study of its kind, the investigators randomized 100 pediatric patients younger than 12 years old to del Nido and cold blood cardioplegia (STH) groups. The patients underwent elective repair of ventricular septal defects and tetralogy of Fallot between August 2014 and July 2015.

Intraoperative parameters and postoperative events were recorded. Cardiac index was calculated at four different time points, while troponin-I, interleukin-6, and tissue necrosis factor-alpha were estimated. The right ventricle was biopsied in order to examine the ultra-structural changes using electron microscopy.

The del Nido group had significantly shorter mean cardiopulmonary bypass time (67 min vs. 78 min) and mean aortic cross-clamp time (40 min vs. 48 min) than the STH group, respectively. “This is very important because long aortic cross-clamp time is an independent risk factor for increased duration of mechanical ventilation, high incidence of low cardiac output syndrome, renal complications, and immediate post-operative mortality,” commented Dr. Talwar.

The total amount of cardioplegia given was significantly higher in STH group (673 mL), compared with the del Nido group (372 mL), according to Dr. Talwar. Overall, the postoperative course was better in the del Nido group with shorter mechanical ventilatory time and ICU stay, faster recovery of cardiac index, and less need for inotropic support.

The researchers biopsied the heart muscle to see if there were microscopic effects of the different cardioplegia agents. Ultrastructural study of myocardium showed no statistically significant difference in data obtained for nuclear changes, mitochondrial changes, sarcoplasmic reticulum, and glycogen depletion. Myofibrillar disarray was significantly more evident in the STH group, while cellular edema was significantly greater in the del Nido group.

Related Articles Read More >

An illustration showing the Edwards Lifesciences Sapien M3 transcatheter mitral valve replacement (TMVR) system's valve being placed in the heart. [Image courtesy of Edwards Lifesciences]
The top nitinol cardiac medtech news of 2025 (so far)
A photo showing the Dualto Energy System's modular design with two generators stacked for two users at a time.
What J&J MedTech’s new Dualto says about the OR of the future — and Ottava
An illustration showing the Edwards Lifesciences Sapien M3 transcatheter mitral valve replacement (TMVR) system's valve being placed in the heart. [Image courtesy of Edwards Lifesciences]
Q&A with Darshin Patel, who led the Edwards Lifesciences Sapien M3 TMVR system’s development
A photo of nitinol, a nickel-titanium alloy used for medical devices such as stents, heart valves, catheters and orthopedics.
What is nitinol and where is it used?
“mdo
EXPAND YOUR KNOWLEDGE AND STAY CONNECTED
Get the latest medical device business news, application and technology trends.

DeviceTalks Weekly

See More >

MDO Digital Edition

Digital Edition

Subscribe to Medical Design & Outsourcing. Bookmark, share and interact with the leading medical design engineering magazine today.

MEDTECH 100 INDEX

Medtech 100 logo
Market Summary > Current Price
The MedTech 100 is a financial index calculated using the BIG100 companies covered in Medical Design and Outsourcing.
DeviceTalks

DeviceTalks is a conversation among medical technology leaders. It's events, podcasts, webinars and one-on-one exchanges of ideas & insights.

DeviceTalks

New MedTech Resource

Medical Tubing

MassDevice

Mass Device

The Medical Device Business Journal. MassDevice is the leading medical device news business journal telling the stories of the devices that save lives.

Visit Website
MDO ad
Medical Design and Outsourcing
  • MassDevice
  • DeviceTalks
  • MedTech100 Index
  • Medical Tubing + Extrusion
  • Medical Design Sourcing
  • Drug Delivery Business News
  • Drug Discovery & Development
  • Pharmaceutical Processing World
  • R&D World
  • About Us/Contact
  • Advertise With Us
  • Subscribe to Print Magazine
  • Subscribe to our E-Newsletter
  • Listen to our Weekly Podcasts
  • Join our DeviceTalks Tuesdays Discussion

Copyright © 2025 WTWH Media, LLC. All Rights Reserved. The material on this site may not be reproduced, distributed, transmitted, cached or otherwise used, except with the prior written permission of WTWH Media LLC. Site Map | Privacy Policy | RSS

Search Medical Design & Outsourcing

  • Home
  • Medical Device Business
    • Mergers & Acquisitions
    • Financial
    • Regulatory
  • Applications
    • Cardiovascular
    • Devices
    • Imaging
    • Implantables
    • Medical Equipment
    • Orthopedic
    • Surgical
  • Technologies
    • Supplies and Components Index
    • Contract Manufacturing
    • Components
    • Electronics
    • Extrusions
    • Materials
    • Motion Control
    • Prototyping
    • Pumps
    • Tubing
  • MedTech Resources
    • Medtech Events in 2025
    • The 2024 Medtech Big 100
    • Medical Device Handbook
    • MedTech 100 Index
    • Subscribe to Print Magazine
    • DeviceTalks
    • Digital Editions
    • eBooks
    • Manufacturer Search
    • Podcasts
    • Print Subscription
    • Webinars / Digital Events
    • Whitepapers
    • Voices
    • Video
  • 2025 Leadership
    • 2024 Winners
    • 2023 Winners
    • 2022 Winners
    • 2021 Winners
  • Women in Medtech
  • Advertise
  • Subscribe