The del Nido cardioplegia in adult cardiac surgery: reinventing myocardial protection?

Myocardial protection is essential in performing successful open heart surgery. Indeed, hypothermia, potassium induced arrest and ventricular offloading are major concepts that have improved surgical results in the last decades. The cold potassium-based cardioplegia given in a single induction dose followed by intervals doses have been adopted by many in their daily practice with good results. However, the ideal myocardial strategy remains elusive.