0bf0ebd0541d97fdff381c0765f697a3 321769.pdf 351286252563b5ab6267b59db6b83100149f5c81 321769.pdf 0f7a7f64f1a1d8879062aff4b12bee3393f894abea245216a622c0caeb79086a 321769.pdf Title: Buckberg versus Del Nido in isolated aortic valve replacement: a prospective, two-centre, randomized trial Subject: Doi: 10.1093/icvts/ivaf054 Interdisciplinary CardioVascular and Thoracic Surgery, 40, 3, 2025 Publication Date: 13/03/2025 Abstract OBJECTIVES Interest in Del Nido solution is increasing in adult cardiac surgery. This study compared Del Nido with Buckberg cardioplegia in patients undergoing isolated aortic valve replacement.METHODS A prospective, two-centre, randomized trial was conducted from July 2019 to August 2023, with adult patients undergoing first-time isolated aortic valve replacement, and were randomized to receive Buckberg (n = 159) or Del Nido (n = 152) solution. Primary end-point was Creatine Kinase and ultrasensitive Troponin T postoperative peak level.RESULTS A total of 311 patients were recruited. Total cardioplegia volume was higher in Del Nido group (1000 ml vs 374.5 ml, P < 0.001). No differences were observed in peak Creatine Kinase or Troponin T levels (422 vs 407 U/L and 282 vs 258 ng/L for Buckberg and Del Nido, respectively) or during postoperative days 1–5. After cross-clamp removal, patients in Del Nido group showed higher rates of spontaneous rhythm (66.7% vs 43.1%, P < 0.001) and less ventricular fibrillation requiring defibrillation (23.6% vs 49.7%, P < 0.001). Peak intraoperative glucose levels (128 mg/dl vs 198 mg/dl, P < 0.001) and insulin administration (18.1% vs 51.0%, P < 0.001) were lower in the Del Nido group. No other differences were found.CONCLUSIONS No differences between Del Nido and Buckberg solutions were detected. Del Nido presents better intraoperative glycaemic control, higher spontaneous rhythm, less ventricular fibrillation requiring defibrillation after cross-clamp removal, and more comfortable surgical workflow due to less re-dose interruptions.CLINICAL REGISTRATION NUMBER EU-CTR number: 2018-002701-59. Keywords: cardioplegia; myocardial protection; Buckberg solution; Del Nido solution; aortic valve replacement Creator: Servigistics Arbortext Advanced Print Publisher 11.1.4667/W Producer: PDFlib+PDI 9.0.7p3 (C++/Win32) CreationDate: Fri Mar 14 12:16:08 2025 CET ModDate: Fri Mar 14 12:16:37 2025 CET Custom Metadata: yes Metadata Stream: yes Tagged: yes UserProperties: no Suspects: no Form: none JavaScript: no Pages: 9 Encrypted: no Page size: 612.283 x 790.866 pts Page rot: 0 File size: 1277035 bytes Optimized: no PDF version: 1.5 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- TIGUOV+MundoSansStd Type 1C Custom yes yes yes 1014 0 TeX_CM_Roman Type 1 Builtin yes no yes 1019 0 NVHLBN+MundoSansStd-Italic Type 1C Custom yes yes yes 1023 0 MYQLIK+MundoSansStd-Bold Type 1C Custom yes yes yes 1028 0 YPIRRX+MundoSansStd-Medium Type 1C Custom yes yes yes 1033 0 TeX_CM_Maths_Symbols Type 1 Builtin yes no yes 1038 0 TCRRBV+STIX-Regular Type 1C Custom yes yes yes 1042 0 TeX_CM_Maths_Italic Type 1 Builtin yes no yes 47 0 HQOXBE+UniversalStd-NewswithCommPi Type 1C Custom yes yes yes 3 0 DANDDT+STIXTwoMath-Regular CID TrueType Identity-H yes yes yes 62 0 PCIPIW+STIX-Bold Type 1C Custom yes yes yes 21 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-11-20 04:07:07 CET RepresentationInformation: 321769.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-11-19 13:41:07 CET Size: 1277035 Format: PDF Version: 1.5 Status: Well-Formed, but not valid SignatureMatches: PDF-hul ErrorMessage: Invalid indirect destination - referenced object 'bivaf054-B15' cannot be found ID: PDF-HUL-149 ErrorMessage: edu.harvard.hul.ois.jhove.module.pdf.PdfInvalidException: Invalid indirect destination - referenced object 'bivaf054-B15' cannot be found ID: PDF-HUL-122 Offset: 1167754 MIMEtype: application/pdf Profile: Tagged PDF PDFMetadata: Objects: 1089 FreeObjects: 1 IncrementalUpdates: 2 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: false CenterWindow: false DisplayDocTitle: true NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseOutlines Language: en Outlines: Item: Title: Active Content List Destination: mkchap_artid Children: Item: Title: INTRODUCTION Destination: mkchap6__sec Item: Title: PATIENTS AND METHODS Destination: mkchap7__sec Item: Title: RESULTS Destination: mkchap13__sec Item: Title: DISCUSSION Destination: mkchap14__sec Item: Title: CONCLUSION Destination: mkchap16__sec Item: Title: SUPPLEMENTARY MATERIAL Destination: mkchap17__sec Item: Title: FUNDING Destination: mkchap18__sec Item: Title: ACKNOWLEDGMENTS Destination: mkchap19_ack1_ack Item: Title: DATA AVAILABILITY Destination: mkchap19__sec Item: Title: Author contributions Destination: mkchap20__sec Item: Title: Reviewer information Destination: mkchap21__sec Item: Title: REFERENCES Destination: mkchap22_ref1_ref-list Info: Title: Buckberg versus Del Nido in isolated aortic valve replacement: a prospective, two-centre, randomized trial Subject: Doi: 10.1093/icvts/ivaf054 Interdisciplinary CardioVascular and Thoracic Surgery, 40, 3, 2025 Publication Date: 13/03/2025 Abstract OBJECTIVES Interest in Del Nido solution is increasing in adult cardiac surgery. This study compared Del Nido with Buckberg cardioplegia in patients undergoing isolated aortic valve replacement.METHODS A prospective, two-centre, randomized trial was conducted from July 2019 to August 2023, with adult patients undergoing first-time isolated aortic valve replacement, and were randomized to receive Buckberg (n = 159) or Del Nido (n = 152) solution. Primary end-point was Creatine Kinase and ultrasensitive Troponin T postoperative peak level.RESULTS A total of 311 patients were recruited. Total cardioplegia volume was higher in Del Nido group (1000 ml vs 374.5 ml, P < 0.001). No differences were observed in peak Creatine Kinase or Troponin T levels (422 vs 407 U/L and 282 vs 258 ng/L for Buckberg and Del Nido, respectively) or during postoperative days 1–5. After cross-clamp removal, patients in Del Nido group showed higher rates of spontaneous rhythm (66.7% vs 43.1%, P < 0.001) and less ventricular fibrillation requiring defibrillation (23.6% vs 49.7%, P < 0.001). Peak intraoperative glucose levels (128 mg/dl vs 198 mg/dl, P < 0.001) and insulin administration (18.1% vs 51.0%, P < 0.001) were lower in the Del Nido group. No other differences were found.CONCLUSIONS No differences between Del Nido and Buckberg solutions were detected. Del Nido presents better intraoperative glycaemic control, higher spontaneous rhythm, less ventricular fibrillation requiring defibrillation after cross-clamp removal, and more comfortable surgical workflow due to less re-dose interruptions.CLINICAL REGISTRATION NUMBER EU-CTR number: 2018-002701-59. Keywords: cardioplegia; myocardial protection; Buckberg solution; Del Nido solution; aortic valve replacement Creator: Servigistics Arbortext Advanced Print Publisher 11.1.4667/W Producer: PDFlib+PDI 9.0.7p3 (C++/Win32) CreationDate: Fri Mar 14 12:46:08 CET 2025 ModDate: Fri Mar 14 12:46:37 CET 2025 ID: 0xf53eb43cddc6d47f6be52bffc9deb107, 0x9aa39604dca03b6cd1da5dd1d35357bd Filters: FilterPipeline: DCTDecode Images: Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 2100 ImageHeight: 1079 BitsPerSample: 8 BitsPerSampleUnit: integer Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 2095 ImageHeight: 1140 BitsPerSample: 8 BitsPerSampleUnit: integer Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 2095 ImageHeight: 665 BitsPerSample: 8 BitsPerSampleUnit: integer Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 2060 ImageHeight: 1499 BitsPerSample: 8 BitsPerSampleUnit: integer Fonts: Type0: Font: BaseFont: DANDDT+STIXTwoMath-Regular Encoding: Identity-H ToUnicode: true Type1: Font: BaseFont: TCRRBV+STIX-Regular FontSubset: true FirstChar: 1 LastChar: 3 FontDescriptor: FontName: TCRRBV+STIX-Regular Flags: Nonsymbolic FontBBox: -970, -486, 2208, 1023 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: HQOXBE+UniversalStd-NewswithCommPi FontSubset: true FirstChar: 1 LastChar: 1 FontDescriptor: FontName: HQOXBE+UniversalStd-NewswithCommPi Flags: Nonsymbolic FontBBox: -7, -227, 989, 764 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: MYQLIK+MundoSansStd-Bold FontSubset: true FirstChar: 1 LastChar: 63 FontDescriptor: FontName: MYQLIK+MundoSansStd-Bold Flags: Nonsymbolic, ForceBold FontBBox: -216, -258, 1142, 886 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: PCIPIW+STIX-Bold FontSubset: true FirstChar: 1 LastChar: 1 FontDescriptor: FontName: PCIPIW+STIX-Bold Flags: Nonsymbolic, ForceBold FontBBox: -998, -552, 2000, 1055 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: TIGUOV+MundoSansStd FontSubset: true FirstChar: 1 LastChar: 84 FontDescriptor: FontName: TIGUOV+MundoSansStd Flags: Nonsymbolic FontBBox: -194, -257, 988, 872 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: YPIRRX+MundoSansStd-Medium FontSubset: true FirstChar: 1 LastChar: 51 FontDescriptor: FontName: YPIRRX+MundoSansStd-Medium Flags: Nonsymbolic FontBBox: -199, -258, 1060, 877 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: TeX_CM_Roman FirstChar: 1 LastChar: 127 FontDescriptor: FontName: TeX_CM_Roman Flags: Symbolic FontBBox: -50, -180, 1000, 720 FontFile: true ToUnicode: true Font: BaseFont: TeX_CM_Maths_Symbols FirstChar: 1 LastChar: 138 FontDescriptor: FontName: TeX_CM_Maths_Symbols Flags: Symbolic FontBBox: -50, -180, 1000, 720 FontFile: true ToUnicode: true Font: BaseFont: NVHLBN+MundoSansStd-Italic FontSubset: true FirstChar: 1 LastChar: 15 FontDescriptor: FontName: NVHLBN+MundoSansStd-Italic Flags: Nonsymbolic, Italic FontBBox: -235, -257, 957, 880 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: TeX_CM_Maths_Italic FirstChar: 1 LastChar: 127 FontDescriptor: FontName: TeX_CM_Maths_Italic Flags: Symbolic FontBBox: -50, -180, 1000, 720 FontFile: true ToUnicode: true CIDFontType2: Font: BaseFont: DANDDT+STIXTwoMath-Regular CIDSystemInfo: Registry: Adobe Registry: Identity Supplement: 0 FontDescriptor: FontName: DANDDT+STIXTwoMath-Regular Flags: Nonsymbolic FontBBox: -978, -1641, 3072, 2627 FontFile2: true XMP: uuid:be9b3c12-9e68-294f-75bc-2fd0c7566ae4 uuid:3FA7A8E6-35C1-187D-788E-BB8E4BFE018F 2025-03-14T16:46:08+05:30 2025-03-14T16:46:37+05:30 Servigistics Arbortext Advanced Print Publisher 11.1.4667/W 2025-03-14T16:46:37+05:30 PDFlib+PDI 9.0.7p3 (C++/Win32) cardioplegia; myocardial protection; Buckberg solution; Del Nido solution; aortic valve replacement Buckberg versus Del Nido in isolated aortic valve replacement: a prospective, two-centre, randomized trial Manel Tauron-Ferrer Elena Roselló-Díez Christian Muñoz-Guijosa Constanza Fernández-DeVinzenzi José Montiel Sandra Casellas Ángela Irabien-Ortiz Laura Corominas-García César Piedra Ignasi Julià Claudio Fernández Virginia Cegarra Nerea Guadalupe Marta Molina Juan F Tabilo Carla Gotsens-Asenjo Cristina Sobre Víctor Gomez Elisabet Berastegui Antonino J Ginel Doi: 10.1093/icvts/ivaf054 Interdisciplinary CardioVascular and Thoracic Surgery, 40, 3, 2025 Publication Date: 13/03/2025 Abstract OBJECTIVES Interest in Del Nido solution is increasing in adult cardiac surgery. This study compared Del Nido with Buckberg cardioplegia in patients undergoing isolated aortic valve replacement.METHODS A prospective, two-centre, randomized trial was conducted from July 2019 to August 2023, with adult patients undergoing first-time isolated aortic valve replacement, and were randomized to receive Buckberg (n = 159) or Del Nido (n = 152) solution. Primary end-point was Creatine Kinase and ultrasensitive Troponin T postoperative peak level.RESULTS A total of 311 patients were recruited. Total cardioplegia volume was higher in Del Nido group (1000 ml vs 374.5 ml, P < 0.001). No differences were observed in peak Creatine Kinase or Troponin T levels (422 vs 407 U/L and 282 vs 258 ng/L for Buckberg and Del Nido, respectively) or during postoperative days 1–5. After cross-clamp removal, patients in Del Nido group showed higher rates of spontaneous rhythm (66.7% vs 43.1%, P < 0.001) and less ventricular fibrillation requiring defibrillation (23.6% vs 49.7%, P < 0.001). Peak intraoperative glucose levels (128 mg/dl vs 198 mg/dl, P < 0.001) and insulin administration (18.1% vs 51.0%, P < 0.001) were lower in the Del Nido group. No other differences were found.CONCLUSIONS No differences between Del Nido and Buckberg solutions were detected. Del Nido presents better intraoperative glycaemic control, higher spontaneous rhythm, less ventricular fibrillation requiring defibrillation after cross-clamp removal, and more comfortable surgical workflow due to less re-dose interruptions.CLINICAL REGISTRATION NUMBER EU-CTR number: 2018-002701-59. © The Author(s) 2025. 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