Evaluation of serum troponin I following the use of a modified-cardioplegia chemical composition for myocardial protection: a case series

Abstract

Heart failure (HF) is a major complication of cardiac surgery. To reduce the incidence of HF, del Nido cardioplegia, a calcium-free hyperkalaemic solution, was developed to reduce intracellular calcium influx that affects the heart following hyperkalaemic arrest. The absence of PlasmaLyte A, a base solution for del Nido cardioplegia, has led to the adoption of Ringerfundin as a substitute. This case series examines the myocardial protection provided by Ringerfundin using postoperative troponin I values. We describe 27 patients who received modified del Nido cardioplegic solutions, finding no significant increment in postoperative troponin I (troponin I value < 6 ng/ml) at 0, 12 and 24 hours and on the third day of blood sampling. Postoperative troponin I values at 24 hours and on the third day fell to near the preoperative values. The modified Ringerfundin-del Nido cardioplegic combination can be a safe alternative during  cardiac surgery requiring continuous antegrade cardioplegia.