The end of the cold era: From intermittent cold to intermittent warm blood cardioplegia

38Citations
Citations of this article
21Readers
Mendeley users who have this article in their library.

Abstract

Background: A major reduction in the energy demand of the myocardium results from the electromechanical arrest, and cooling contributes to a lesser degree to this reduction. It is from this assumption that strategies of myocardial protection, utilizing warm blood cardioplegic induction, followed by cold cardioplegia with terminal warm reperfusion before removal of the aortic cross clamp, became established as optimal myocardial protection. Continuous normothermic perfusion 'closed the loop' by avoiding myocardial ischemia and linking warm induction and terminal reperfusion. A series of laboratory and clinical data confirmed the benefits of warm heart surgery on myocardial function and metabolism. The disadvantages of continuous warm blood cardioplegia including disturbance of the operative field, led surgeons to administer warm hyperkalaemic blood intermittently as a new cardioplegic strategy. Methods: This review examines the laboratory and clinical data with reference to the intermittent warm blood cardioplegia, to establish its experimental basis and place in clinical practice. Conclusions: Experimental observation and clinical application have established intermittent warm blood cardioplegia as a practical, effective and cheap myocardial protection technique, particularly with reference to coronary artery surgery.

Cite

CITATION STYLE

APA

Caputo, M., Ascione, R., Angelini, G. D., Suleiman, M. S., & Bryan, A. J. (1998, November). The end of the cold era: From intermittent cold to intermittent warm blood cardioplegia. European Journal of Cardio-Thoracic Surgery. https://doi.org/10.1016/S1010-7940(98)00233-4

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free