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Composition of cardioplegia solutions (approximate values in final composition of 4 parts blood and 1 part cardioplegia solution).

Composition of cardioplegia solutions (approximate values in final composition of 4 parts blood and 1 part cardioplegia solution).

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Figure 1. Comparison of creatine kinase-MB (CPK-MB) levels between the...
Table 1 . Composition of cardioplegia solutions (approximate values in...
Figure 2. Troponin I levels in the two groups. L: long-acting blood...
Table 2 . Patient characteristics and measured variables.
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Normokalemic nondepolarizing long-acting blood cardioplegia
Article
Full-text available
  • Oct 2017
Objective Blood cardioplegia, the gold-standard cardioprotective strategy, requires frequent dosing, resulting in hyperkalemia-induced myocardial edema. The aim of our study was to compare the efficacy and safety of a long-acting blood-based cardioplegia with physiological potassium levels versus the well-established cold blood St. Thomas’ Hospital...
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... topical cooling used. The composition of both cardioplegia solutions is given in Table 1. ...

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... This alternative concept, polarized arrest, has several potential advantages, proven in both experimental and clinical studies. [6][7][8][9] Still, the use of polarized cardioplegic arrest is not widely established clinically. ...
Left ventricular dysfunction after two hours of polarizing or depolarizing cardioplegic arrest in a porcine model
Article
Full-text available
  • Jul 2018
  • Perfusion
Introduction: This experimental study compares myocardial function after prolonged arrest by St. Thomas' Hospital polarizing cardioplegic solution (esmolol, adenosine, Mg2+) with depolarizing (hyperkalaemic) St. Thomas' Hospital No 2, both administered as cold oxygenated blood cardioplegia. Methods: Twenty anaesthetized pigs on tepid (34°C) cardiopulmonary bypass (CPB) were randomised to cardioplegic arrest for 120 min with antegrade, repeated, cold, oxygenated, polarizing (STH-POL) or depolarizing (STH-2) blood cardioplegia every 20 min. Cardiac function was evaluated at Baseline and 60, 150 and 240 min after weaning from CPB, using a pressure-conductance catheter and epicardial echocardiography. Regional tissue blood flow, cleaved caspase-3 activity and levels of malondialdehyde were evaluated in myocardial tissue samples. Results: Preload recruitable stroke work (PRSW) was increased after polarizing compared to depolarizing cardioplegia 150 min after declamping (73.0±3.2 vs. 64.3±2.4 mmHg, p=0.047). Myocardial tissue blood flow rate was high in both groups compared to the Baseline levels and decreased significantly in the STH-POL group only, from 60 min to 150 min after declamping (p<0.005). Blood flow was significantly reduced in the STH-POL compared to the STH-2 group 240 min after declamping (p<0.05). Left ventricular mechanical efficiency, the ratio between total pressure-volume area and blood flow rate, gradually decreased after STH-2 cardioplegia and was significantly reduced compared to STH-POL cardioplegia after 150 and 240 min (p<0.05 for both). Conclusion: Myocardial protection for two hours of polarizing cardioplegic arrest with STH-POL in oxygenated blood is non-inferior compared to STH-2 blood cardioplegia. STH-POL cardioplegia alleviates the mismatch between myocardial function and perfusion after weaning from CPB.
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