OBJECTIVE We have recently shown that adenosine instead of supranormal potassium in cold crystalloid cardioplegia improves cardioprotection. Studies indicate that hyperkalemia has unfavorable effects on vascular endothelial function. Three pathways have been identified as major vasodilatory pathways: the nitric oxide (NO) pathway, the cyclooxygenase (COX) pathway, and the endothelium-derived hy...

The combination of hypothermia and potassium cardioplegic arrest has become the most common method of myocardial protection in the evolution of myocardial protection. This review focuses on myocardial protection in pediatric cardiac surgery. In the 1980s, blood was added to cardioplegia solution in order to supply the myocardium with oxygen, nutrients, and for buffering purposes. Similar myocar...

OBJECTIVE Due to limited resources, improvement of preservation solutions is still of great importance in cardiac transplant surgery. New additives with antioxidant properties were tested with respect to coronary function of isolated rat hearts. METHODS Bretschneider HTK solution containing none or an antioxidant additive (deferoxamine, trolox or LK 616) was used for 8h cold cardioplegia. Aft...

Although cardioplegia reduces myocardial metabolism during ischemia, adenosine triphosphate (ATP) depletion occurs, which may contribute to poor functional recovery after reperfusion. Augmenting myocardial adenosine during ischemia is successful in improving ATP repletion and myocardial recovery following ischemia. If adenosine is an important determinant of ischemic tolerance, then depletion o...

Despite surgical proficiency and innovation driving low mortality rates in cardiac surgery, the disease severity, comorbidity rate, and operative procedural difficulty have increased. Today's cardiac surgery patient is older, has a "sicker" heart and often presents with multiple comorbidities; a scenario that was relatively rare 20 years ago. The global challenge has been to find new ways to ma...

-----------------------------------.... Retrograde coronary sinus perfusion may provide equal if not better myocardial protection than antegrade cardioplegia during certain heart surgeries. The coronary venous system can be divided into the greater and lesser systems and veno-venous and arterio-venous anastomoses. Venous drainage varies greatly and retrograde coronary sinus perfusion depends on...

No data exist in the English-language literature about patients with Barlow disease associated to Steinert syndrome and little is known about the employment of hypothermic cardiopulmonary bypass (CPB) and hyperkalemic cardioplegia in these patients. We present our experience with six patients affected by myxomatous degeneration associated to Steinert disease undergoing complex mitral valve repa...

BACKGROUND Del Nido cardioplegia, a crystalloid-based solution with lidocaine as a key element, is given as a single dose and has been used successfully in congenital cardiac surgery. HYPOTHESIS We retrospectively compared a lidocaine containing "modified del Nido" solution with our standard whole blood cardioplegia to investigate its safety and efficacy in adult cardiac surgery. METHODS Fr...

Cold agglutinins are of unique relevance in cardiac surgerybecause of the use of hypothermic cardiopulmonary bypass (CPB). Cold autoimmune diseases are defined by the presence of abnormal circulating proteins (usually IgM or IgA antibodies) that agglutinate in response to a decrease in body temperature. These disorders include cryoglobulinemia and cold hemagglutinin disease.Immunoglobulin M aut...

1 Anaesthesia Dept., Faculty of Medicine, Ain Shams Univ., Egypt. 2 Anaesthesia Dept., Faculty of Medicine, El-Fayum Univ., Egypt. 3 Cardiac surgery Dept., Faculty of Medicine, El Azhar Univ., Egypt. -----------------------------------------------------------------------------------------------------Abstract: There is still a debate about the cardioplegia administration method in patients with ...