What is crystalloid cardioplegia?
Cardioplegia protects the heart from ischemic injury and postoperative heart failure during cardiopulmonary arrest period. Initially crystalloid cardioplegia was introduced as an agent to allow for hypothermic hyperkalemic arrest.
How does cardioplegia solution work?
Cardioplegic solution is the means by which the ischemic myocardium is protected from cell death. This is achieved by reducing myocardial metabolism through a reduction in cardiac work load and by the use of hypothermia.
What is antegrade cardioplegia?
When solution is introduced into the aortic root (with an aortic cross-clamp on the distal aorta to limit systemic circulation), this is called antegrade cardioplegia. When introduced into the coronary sinus, it is called retrograde cardioplegia.
What is Sondergaard’s groove?
Posterior and parallel to the terminal groove is a second, deeper groove between the right atrium and the right pulmonary veins. Dissections into this deep interatrial groove, also known as Waterston’s or Sondergaard’s groove, permit incisions to be made into the left atrium (Fig. 47-9).
What is St Thomas solution?
Thomas’ Hospital cardioplegic solution number 2. This cardioplegic solution (NaCl 110.0 mM, NaHCO3 10.0 mM, KCl 16.0 mM, MgCl2 16.0 mM, CaCl2 1.2 mM, pH 7.8) is designed for routine clinical use combining optimal protection with simplicity of formulation and administration/infusion.
Why is it difficult to compare blood types For crystalloid cardioplegia?
Comparing blood with crystalloid cardioplegia is extremely difficult because the reasons for selecting alternate cardioplegic methods are not adequately determined with the usual patient demographics. Experienced cardiac surgeons tailor their myocardial protection strategies to the anticipated procedure.
Are blood and crystalloid cardioplegia effective in pediatric cardiac surgery?
Objective: Blood and crystalloid cardioplegia are the main myocardial protective solutions used in pediatric cardiac surgery. However, the effectiveness of these two solutions on myocardial metabolism, reperfusion injury and clinical outcomes in pediatric patients is still under debate.
Is myocardial metabolism better in blood cardioplegia?
Myocardial metabolism was better in the blood cardioplegia group compared with the crystalloid cardioplegia group. However, there was no evidence of improvement in myocardial damage or clinical outcome for either cardioplegia solution. Myocardial metabolism was better in the blood cardioplegia group compared with the crystalloid cardioplegia group.
Is crystalloid cardioplegia suitable for CABG or valve surgery?
The optimal technique of crystalloid cardioplegia has not been established for either isolated CABG or valve surgery. The best method of blood cardioplegic delivery depends on the cardiac procedure anticipated.