We present the technical details of blood cardioplegia as the standard clinical practice in most centers today. In addition, the contribution refers to the advanced strategies using blood cardioplegia in specific situations, including warm cardioplegia induction, controlled reperfusion in acute myocardial infarction, and the application of leucocyte filtration.

Objective: Nonhomogeneous distribution of cardioplegia antegradely in severe coronary artery stenosis and evolving acute myocardial infarction has been demonstrated experimentally. Administration of cardioplegia retrogradely causes homogeneous distribution and offers a good alternative for myocardial protection. Methods: Thirty five consecutive patients with three vessel-disease undergoing elec...

BACKGROUND The aim of this study was to determine whether warm reperfusion improves myocardial protection with cardiac troponin I as the criteria for evaluating the adequacy of myocardial protection. METHODS One hundred five patients undergoing first-time elective coronary bypass surgery were randomized to one of three cardioplegic strategies of either (1) cold crystalloid cardioplegia follow...

OBJECTIVE To experimentally compare the structural and ultrastructural changes in isolated hypertrophied rabbits' hearts submitted to cardiac arrest protected using sanguineous and crystalloid cardioplegia solutions. METHOD The study comprised two experimental groups and one control group. In Experimental Group I, cardiac arrest was achieved by the continuous infusion of tepid sanguineous car...

Cardioplegia has become the gold standard of myocardial protection for practically every type of heart surgery during which the ascending aorta must be clamped. Although there is little doubt about the efficacy of cardioplegia in the adult heart, there are few studies on the pediatric heart and their results are contradictory. The physiology of pediatric heart muscle differs considerably from t...

INTRODUCTION St. Thomas' cardioplegic solution No. 2 (ST), although most widely used in adult cardiac surgery, needs to be given at short intervals, causing additional myocardial injury. AIM To determine whether del Nido (DN) cardioplegia, with longer periods of arrest, provides equivalent myocardial protection as compared to ST. MATERIAL AND METHODS The study population comprised 100 patie...

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 for...

OBJECTIVES A single or dual-dose strategy for myocardial protection is attractive in long operations, in avoiding the need to interrupt the procedure to re-administer cardioplegia. We hypothesized that a single administration of Bretschneider histidine-tryptophan-ketoglutarate (HTK) crystalloid solution (Custodiol) offers myocardial protection comparable with repeated tepid blood cardioplegia. ...

BACKGROUND Many small, randomized, controlled trials have evaluated the effectiveness of blood as compared with crystalloid cardioplegia for myocardial protection during cardiac surgery. Blood cardioplegia provides a closer approximation to normal physiology, which may translate into measurable clinical benefits. This meta-analysis describes the effectiveness of blood cardioplegia in lowering a...

I read with interest the article by Steensrud and colleagues on myocardial protection with nicorandil cardioplegia [1]. The study investigates the protective efficacy of intermittent cold blood nicorandil cardioplegia compared with intermittent standard hyperkalemic cold blood and cold crystalloid cardioplegia in pigs undergoing cardiopulmonary bypass and hearts subjected to 60 min global ische...