CLINICAL-EXPERIENCE WITH BLOOD CARDIOPLEGIA

Since its initial description, blood cardioplegia has become the prefe rred tool to arrest the heart for open heart surgery in both children and adults. This shift from crystalloid-type cardioplegia to blood car dioplegia occurred because experimental and clinical studies demonstra ted superior protection of the arrested myocardium by blood cardiopleg ia. In this article we review and describe the different strategies an d 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 (ante grade, retrograde, or both), and/or the temperature of the solution. I n order to maxime myocardial protection, specific protocols for the ad ministration of blood cardioplegia have been designed for specific cli nical conditions. We further define the indications for the use of the different protocols. Our own clinical experience with blood cardiople gia is corroborated with the concepts and results described in the lit erature. We conclude that blood cardioplegia is 1.) an effective way t o safely arrest the myocardium for cardiac operations, 2.) affords exc ellent myocardial protection, and 3.) allows for quick recovery of con tractile function upon reperfusion.