What is hot shot cardioplegia?
Warm blood hyperkalaemic reperfusion (‘hot shot’) prevents myocardial substrate derangement in patients undergoing coronary artery bypass surgery.
How do you administer cardioplegia?
Anterograde cardioplegia is administered into a small cannula placed in the ascending aorta or directly into the coronary ostia. Retrograde cardioplegia is delivered through a catheter placed through the right atrium into the coronary sinus. Cardioplegia is then delivered into the venous system of the heart.
What is cold cardioplegia?
Cold cardioplegia is given into the heart through the aortic root. Blood supply to the heart arises from the aortic root through coronary arteries. Cardioplegia in diastole ensures that the heart does not use up the valuable energy stores (adenosine triphosphate).
How does del Nido work?
The del Nido cardioplegia is delivered with 20% by volume fully oxygenated patient blood, which supports aerobic metabolism for a finite period of time and provides buffering properties to promote anaerobic glycolysis as well.
What should be the temperature of warm cardioplegia?
Optimal Temperature. Most investigators have reported using warm cardioplegia at 37 °C, and others, at temperatures above 35 °C. In contrast, cold cardioplegia temperatures range between 4 and 15 °C, most below 10 °C.
What is cardioplegia solution?
Cardioplegia Solution A is a sterile, non-pyrogenic solution for cardiac perfusion in a Viaflex bag. It is used to induce cardiac stasis and to protect the myocardium during open-heart surgery.
Where is cardioplegia injected?
The anterograde cardioplegia is inserted in the proximal aorta and contains three lumens: one to administer the cardioplegia, another for suctioning, and the third to measure intraluminal pressure.
When should I Redose del Nido cardioplegia?
A multitude of studies have demonstrated equivalent myocardial protec- tion compared with conventional cold blood cardioplegia in adult cardiac surgery, with the advantage of a single dosing regimen. Expert opinion suggests redosing if the ischemic time is likely to extend much beyond 90 mi- nutes.
What is in buckberg cardioplegia?
Modified Buckberg cardioplegia is a dextrose-based solution in normal saline with potassium chloride as the depolarizing agent, tromethamine as the buffer, and citrate phosphate double dextrose as a calcium chelator and delivered 4:1 oxygenated patient’s blood to crystalloid.
What is the most suitable body temperature for cardiopulmonary bypass?
Temperature — Mild (32 to 35°C), moderate (28 to 32°C), or deep (<28°C) hypothermia is used as a protective strategy for the brain and vital organs during CPB for many cardiac surgical procedures [98-100].
Which patient is at a high risk for myocardial infarction MI )?
Your risk is especially high if you have male family members who developed heart disease before age 55 or if you have female family members who developed heart disease before age 65.
How is antegrade cardioplegia (AC) administered?
Unless there is significant aortic insufficiency, antegrade cardioplegia is generally given via a small catheter positioned in the root of the aorta proximal to the cross-clamp.
How do you decompress the ventricle during cardioplegia?
An LV vent can be placed (typically via a pulmonary vein) to decompress the ventricle while cardioplegia is being administered if needed. ME views of the mitral valve and LV can be used to ensure that the LV vent actually crosses the mitral valve and that the tip resides in the LV.
What is the cardioplegia pump?
This portion of the blood is delivered via a separate pump (the cardioplegia pump) and separately adjusted regarding temperature and pressure. Later, when CPB is complete and the heart function is no longer needed to eject blood into the body, an aortic cross-clamp is applied to the proximal aorta.
What is a retrograde cardioplegia cannula during CPB?
Cannuli and vents during CPB: Retrograde cardioplegia cannula is seen in the coronary sinus, and LV vent is seen traversing the MV into the LV (appears as a double-dashed line) (Figure 18.4 ). Intraaortic balloon pump (IABP): First, examine the descending aorta for atheromatous plaque.