Abstract
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.
Key words
Myocardial protection - Ischemia - Cardiac surgery - Reperfusion
