What is cardioplegia del Nido

Del Nido cardioplegia was developed by Pedro Del Nido and his team at the University of Pittsburgh in 1990s. It has been used for pediatric cardiac surgery in Boston’s Children Hospital since 1994 and, since 2003, it has been successfully used for adult cardiac surgery as well [8].

What is Microplegia?

Microplegia (whole blood cardioplegia with reduced volume) retains all the advantages of blood cardioplegia (such as superior oxygen-carrying capacity, better osmotic properties and antioxidant capability, etc.) without the potential disadvantages of hemodilution (such as myocardial edema).

What is cardioplegia made of?

Each 100 mL of solution contains Calcium Chloride Dihydrate USP 17.6 mg, Magnesium Chloride, Hexahydrate USP 325.3 mg, Potassium Chloride USP 119.3 mg and Sodium Chloride USP 643 mg in Water for Injection, USP.

What is the purpose of cardioplegic solution?

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.

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 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 cold blood cardioplegia?

The technique of myocardial protection by means of a cardioplegic solution consisting of cold blood (10 degrees C) with potassium (30 mEq. per liter) is described. A disposable cooling coil is used and a separate pump head for coronary perfusion is avoided.

What is antegrade cardioplegia?

When solution is introduced into the aortic root (with an aortic cross-clamp on the distal aorta to limit systemic circulation), this is called antegrade cardioplegia. When introduced into the coronary sinus, it is called retrograde cardioplegia.

What are the types of cardioplegia?

One of the most important myocardial protection techniques is cardioplegia – indirect or direct administration of cardioplegic solution to the coronary arteries. Both crystalloid cardioplegia and blood cardioplegia are widely used in pediatric cardiac surgery [1–3].

Why does the heart stop in systole in hypercalcemia?

At the end of the action potential plateau, influx of calcium ions into muscle fibers is suddenly interrupted, and the calcium ions in the sarcoplasm are rapidly pumped back into the sarcoplasmic reticulum and t-tubules, thereby ending contraction until the next action potential.

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What causes stone heart?

Stone heart has occurred only during aortic valve replacement and/or coronary artery bypass procedures. Predisposing factors are chronic congestive heart failure and myocardial hypertrophy with fibrosis secondary to longstanding aortic valve disease and/or coronary artery occlusive disease.

Where is cardioplegia given?

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.

Why potassium is used in cardioplegia?

The potassium in the cardioplegic solution serves to stop the heart rapidly before its metabolic stores are depleted, while hypo- thermia reduces the energy requirements of the heart during anoxia [2].

Who invented cardioplegia?

The term cardioplegia (cardio, heart and plegia, paralysis) was first introduced by Lam in 1957 (Lam et al., 1957), yet the method of arrest has its roots in the early experiments of British physiologist Sidney Ringer using the frog heart (Figure 2).

How do you ReVerse cardioplegia?

The ReVerse cardioplegia circuit system is a description of a two-pump cardioplegia circuit which is adaptable to either blood or crystalloid cardioplegia. The change from one mode to another requires a manoeuvre of two clamps, allowing the blood solution to travel through shunt tubing into the apposite pumphead.

What drug is used to stop the heart during surgery?

The surgeon infuses a chemical agent (cardioplegia) which stops the heart’s function. The solution contains potassium ion which has a quieting effect on the heart.

What is crystalloid cardioplegia?

Cardioplegia protects the heart from ischemic injury and postoperative heart failure during cardiopulmonary arrest period. Initially crystalloid cardioplegia was introduced as an agent to allow for hypothermic hyperkalemic arrest.

What is hot shot cardioplegia?

Warm blood hyperkalaemic reperfusion (‘hot shot’) prevents myocardial substrate derangement in patients undergoing coronary artery bypass surgery.

What is Sondergaard's groove?

Posterior and parallel to the terminal groove is a second, deeper groove between the right atrium and the right pulmonary veins. Dissections into this deep interatrial groove, also known as Waterston’s or Sondergaard’s groove, permit incisions to be made into the left atrium (Fig. 47-9).

How does Custodiol cardioplegia work?

Custodiol® solution, also called histidine-tryptophan-ketoglutarate (HTK) or Bretschneider’s solution, is a particular kind of long-acting intracellular crystalloid cardioplegia (CCP) that differs from other extracellular cardioplegic solutions because of its low sodium and potassium content that induce the diastolic …

Who administers cardioplegia?

[13] The cardiothoracic anesthesiologist will assist in confirming the position of the retrograde cardioplegia catheter placed by the cardiothoracic surgeon on TEE and also facilitates the assessment of the atherosclerosis of the ascending aorta for clamping and cannulation.

Where is antegrade cardioplegia?

Antegrade cannulae are designed to deliver cardioplegia solution to the heart via the coronary ostia in the normal direction of blood flow (antegrade perfusion).

Is the coronary sinus?

Coronary sinusLatinSinus coronariusMeSHD054326TA98A12.3.01.002TA24158

When is retrograde cardioplegia used?

Retrograde coronary sinus cardioplegia is being used for myocardial protection with ever-increasing frequency during complex cardiac operations. New methods for introducing cardioplegia into the coronary sinus have been facilitated by improved balloon-tipped catheters.

What does hypercalcemia do to the heart?

Severe hypercalcemia can lead to confusion, dementia and coma, which can be fatal. Abnormal heart rhythm (arrhythmia). Hypercalcemia can affect the electrical impulses that regulate your heartbeat, causing your heart to beat irregularly.

What is the most common cause of hyperkalemia?

The most common cause of genuinely high potassium (hyperkalemia) is related to your kidneys, such as: Acute kidney failure. Chronic kidney disease.

What does calcium gluconate do to the heart?

Rapid intravenous injections of calcium gluconate may cause hypercalcaemia, which can result in vasodilation, cardiac arrhythmias, decreased blood pressure, and bradycardia. Extravasation of calcium gluconate can lead to cellulitis.

How do you become a stone hearted person?

In order to become a stone heart person one needs to demolish these lies we tell ourselves and instead come up with rational beliefs which promise personal growth, success and peace in life.

What does a stone heart mean?

Definition of a heart of stone : an inflexible and unfriendly or unkind disposition She has a heart of stone.

Does digoxin affect potassium levels?

Digoxin toxicity causes hyperkalemia, or high potassium. The sodium/potassium ATPase pump normally causes sodium to leave cells and potassium to enter cells. Blocking this mechanism results in higher serum potassium levels.

Where is coronary sinus located?

The coronary sinus is a collection of smaller veins that merge together to form the sinus (or large vessel), which is located along the heart’s posterior (rear) surface between the left ventricle and left atrium.