EXPORT CITATION

Chapter-24 Myocardial Protection during Cardiac Surgery: An Overview of Cardioplegia

BOOK TITLE: Yearbook of Anesthesiology-7

Author
1. Tempe Deepak K
2. Saigal Deepti
ISBN
9789352702978
DOI
10.5005/jp/books/14141_25
Edition
1/e
Publishing Year
2018
Pages
21
Author Affiliations
1. Maulana Azad Medical College and Associated GB Pant, Guru Nanak Eye Center (GNEC) and Lok Nayak Hospitals, New Delhi, India, Maulana Azad Medical College and GB Pant Hospital, New Delhi, India, GB Pant Institute of Postgraduate Medical Education and Research, New Delhi, India, tempedeepak@hotmail.com
2. Safdarjung Hospital and Vardhaman Mahavir Medical College, New Delhi, India, deeptisaigal21@gmail.com
Chapter keywords
Cardioplegia, coronary artery stenosis, aortic regurgitation, myocardium, hyperkalemia, hyperglycemia, coronary artery bypass graft, CABG, cardiopulmonary bypass, CPB, low cardiac output syndrome, LCOS

Abstract

The word cardioplegia meaning heart and plege meaning stroke. Hence, literally cardioplegia means paralysis of the heart. Aortic cross clamping followed by administration of cardioplegia solution to achieve pharmacologically induced electromechanical cessation of the cardiac activity is an accepted practice during cardiac surgeries. Cardioplegia can be delivered to the myocardium in an antegrade (via aorta or coronary artery) or retrograde (coronary sinus or right atrium) fashion. While antegrade delivery helps achieve instant cardiac arrest, retrograde delivery is a more reliable route in coronary artery stenosis and aortic regurgitation. The combined route employing antegrade induction and retrograde route for continuous or repeat delivery has become an accepted practice. Continuous warm blood cardioplegia ensures a continuous supply of oxygen and energy substrates to the heart thus producing “aerobic arrest”.

Related Books

© 2019 Jaypee Brothers Medical Publishers (P) LTD.   |   All Rights Reserved