During open heart surgery it is important for the heart to be temporarily still without bleeding yet protected from ischemic injury.
Cardioplegia refers to a temporary and reversible cardiac arrest. This historically was achieved by use of supraphysiologic concentration of potassium.
Purposes:
(1) reduce myocardial oxygen demand by causing electrical quiescence
(2) prevents cardiac movement in the surgical field
(3) provides a relatively bloodless surgical field
Addition of cooling the heart further reduces the ischemic effect of cardiac bypass.
There are a variety of cardioplegic solutions and methods with various benefits and problems.
Types of cardioplegia:
(1) del Nido
(2) blood cardioplegia
(3) St. Thomas
(4) histidine-tryptophan-ketoglutarate (HTK)
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