Cardioplegia Practices in Elective Adult Coronary Artery Bypass Surgery: A National Survey

Duygu Durmaz1, Sedat Gündöner2, Hayrettin Tekümit1

1Department of Cardiothoracic and Vascular Surgery, Bandırma 17 Eylül University Faculty of Medicine, Balıkesir, Türkiye
2Department of Cardiothoracic and Vascular Surgery, Bandırma Training and Research Hospital, Balıkesir, Türkiye

Keywords: Cardioplegia; cabg; myocardial protection questionnaire.

Abstract

Objective: This study aimed to determine current cardioplegia practices in coronary artery bypass grafting surgery in Türkiye and variations according to the preferred cardioplegia type.

Methods: A 16-item questionnaire was distributed to members of the Turkish Society of Cardiovascular Surgery involved in adult cardiac surgery between November 2023 and February 2024. The questions addressed cardioplegia type, temperature, dose, delivery method, redosing interval, topical cooling, and hot-shot use.

Results: A total of 204 responses were analyzed. Blood cardioplegia was used by 69 (33.8%) participants, microplegia by 68 (33.3%), and Del Nido cardioplegia by 60 (29.4%). Most participants preferred a cardioplegia temperature of 4–10 °C (56.4%). Topical cardiac cooling was routinely used by 41.7%, and hot-shot administration by 47.1%. Antegrade cardioplegia alone was used by 59.3%, whereas 40.7% used combined antegrade and retrograde delivery. The roller pump was the most frequently preferred delivery technique (51.0%). The most common redosing interval was 15–20 minutes for blood cardioplegia (60.9%) and 60–90 minutes for Del Nido cardioplegia (71.7%). The most common blood-to-crystalloid ratios were 4:1 for blood cardioplegia (92.8%) and 1:4 for Del Nido cardioplegia (61.7%).

Conclusion: Cardioplegia practices in adult coronary artery bypass surgery vary considerably in Türkiye. Blood-based cardioplegia remains the predominant strategy. Further studies should investigate the associations between cardioplegia practices, myocardial protection markers, and postoperative outcomes.

Cite This Article: Durmaz D, Gündöner S, Tekümit H. Cardioplegia Practices in Elective Adult Coronary Artery Bypass Surgery: A National Survey. Koşuyolu Heart J 2026;29(3):175–180