Clinical experience with blood cardioplegia.
Since its initial description, blood cardioplegia has become the preferred tool to arrest the heart for open heart surgery in both children and adults. This shift from crystalloid-type cardioplegia to blood cardioplegia occurred because experimental and clinical studies demonstrated superior protection of the arrested myocardium by blood cardioplegia. In this article we review and describe the different strategies and protocols which have evolved for the use of blood cardioplegia under different conditions. The protocols differ in the composition of the crystalloid component of the solution, the direction of delivery (antegrade, retrograde, or both), and/or the temperature of the solution. In order to maxime myocardial protection, specific protocols for the administration of blood cardioplegia have been designed for specific clinical conditions. We further define the indications for the use of the different protocols. Our own clinical experience with blood cardioplegia is corroborated with the concepts and results described in the literature. We conclude that blood cardioplegia is 1.) an effective way to safely arrest the myocardium for cardiac operations, 2.) affords excellent myocardial protection, and 3.) allows for quick recovery of contractile function upon reperfusion.
Schlensak
C
C
Division of Cardiovascular Surgery, University Clinic Freiburg, Germany.
Doenst
T
T
Beyersdorf
F
F
D000328:Adult; D002315:Cardiopulmonary Bypass; D002648:Child; D006324:Heart Arrest, Induced / Q000379:methods; D006331:Heart Diseases / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D009200:Myocardial Contraction; D015425:Myocardial Reperfusion