History and Use of del Nido Cardioplegia Solution at Boston Children’s Hospital

TLDR

Cardioplegia is essential for myocardial protection during cardiac surgery, and although many solutions exist, the del Nido solution has been used at Boston Children’s Hospital for 18 years and is increasingly adopted for adult procedures. The study presents the developmental history, theory, and current protocol for del Nido cardioplegia. Del Nido cardioplegia is a four‑part crystalloid‑to‑one‑part whole‑blood solution typically delivered as a single dose. Interest in del Nido cardioplegia has risen nationally and internationally, with inquiries to our institution increasing over the past two years.

Abstract

Cardioplegia is an integral and essential method of myocardial protection for patients of all ages requiring cardiac surgery in which the heart must be stopped. Numerous cardioplegia solutions and delivery methods have been developed. The del Nido cardioplegia solution has been in use for 18 years at Boston Children’s Hospital. This is a unique four parts crystalloid to one part whole blood formulation that is generally used in a single-dose fashion. Although the formulation was originally developed for use in pediatric and infant patients, its use for adult cardiac surgery has been expanding. National and international inquiries to our institution regarding this cardioplegia have been increasing over the last 2 years. We present the developmental history, supporting theory, and current protocol for use of what is now referred to as del Nido cardioplegia.