Intermittent antegrade intermediate lukewarm blood cardioplegia is appropriate and clinically safe. Cardiac troponin I release suggests that intermediate lukewarm cardioplegia is better than cold cardioplegia but less effective than warm cardioplegia in low-risk patients. We therefore recommend the use of warm cardioplegia in low-risk patients.
A case of postinfarction left ventricular free wall rupture is successfully treated. Prompt diagnosis was provided by echocardiography and an emergency operation was carried out. Following sternotomy, hemodynamic stabilization was obtained by gradually evacuating blood from the pericardium, while the femoral vessels were cannulated and the extracorporeal circulation was established. An autologous glutaraldehyde stiffened pericardial patch was sealed over the infarcted area using fibrin glue and fixed with a running suture on the surrounding healthy myocardium.
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